Glutamine supplementation: Is it beneficial to critically ill children?

• Autor(a) principal: PACÍFICO, Stefânia Lucizani
• Data de Publicação: 2023
• Outros Autores: Pons LEITE, Heitor, Brunow de CARVALHO, Werther
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista de Nutrição
• Texto Completo: https://periodicos.puc-campinas.edu.br/nutricao/article/view/9812
• topic: child; glutamine; enteral nutrition; parenteral nutrition; suplementary feeding; intensive care; criança; glutamina; nutrição enteral; nutrição parenteral; suplementação; terapia intensiva

Although there have been several randomized trials, conducted with critically ill adults, reporting the benefitsof glutamine supplementation, there is scarce information on the role of glutamine in the treatment outcomeof critically ill children. Our objective was to evaluate existing studies on the effect of glutamine supplementation,aiming at verifying the clinical benefits of such supplementation for critically ill children. A computerizedsearch was conducted to select prospective, randomized, clinical trials of critically ill children, publishedbetween 1992 and 2003. Studies were included if, besides presenting the characteristics already mentioned,they evaluated the effects of parenteral and the enteral glutamine supplementing vs. those of standard care.The variables on clinical outcomes were: time to achieve full enteral nutrition, hospital length of stay,complication rates, and mortality. Three bibliographic databases were searched: Medline, LILACS and CochraneLibrary. Search terms included: glutamine, critically ill, trauma, sepsis, burned, injured, bone marrowtransplantation, intensive care, and mechanic ventilation. Initial screening resulted in 33 original articles; ofthese potentially eligible articles, only 7 fulfilled the inclusion criteria. Length of hospital stay, mortality rate,and hospital costs were not different for patients receiving glutamine-supplemented nutrition, when comparedto those receiving non-supplemented diet. Glutamine was associated with reduction in the time necessary toachieve full enteral feeding and parenteral nutrition. There is no evidence to support the routine use of eitherparenteral or enteral glutamine supplement when treating critically ill children. The small number of patients,heterogeneity with respect to the studied groups, routes of administration, and confounding effects ofconcomitant diseases, all limit the inferences we can make from the results.