Monitoring the clinical introduction of a glutamine and antioxidant solution in critically ill trauma and burn patients.

Details

Serval ID
serval:BIB_B77A73B7858D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Monitoring the clinical introduction of a glutamine and antioxidant solution in critically ill trauma and burn patients.
Journal
Nutrition
Author(s)
Soguel L., Chioléro R.L., Ruffieux C., Berger M.M.
ISSN
0899-9007 (Print)
ISSN-L
0899-9007
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
24
Number
11-12
Pages
1123-1132
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Enteral glutamine supplementation and antioxidants have been shown to be beneficial in some categories of critically ill patients. This study investigated the impact on organ function and clinical outcome of an enteral solution enriched with glutamine and antioxidant micronutrients in patients with trauma and with burns.
This was a prospective study of a historical control group including critically ill, burned and major trauma patients (n = 86, 40 patients with burns and 46 with trauma, 43 in each group) on admission to an intensive care unit in a university hospital (matching for severity, age, and sex). The intervention aimed to deliver a 500-mL enteral solution containing 30 g of glutamine per day, selenium, zinc, and vitamin E (Gln-AOX) for a maximum of 10 d, in addition to control treatment consisting of enteral nutrition in all patients and intravenous trace elements in all burn patients.
Patients were comparable at baseline, except for more inhalation injuries in the burn-Gln-AOX group (P = 0.10) and greater neurologic impairment in the trauma-Gln-AOX group (P = 0.022). Intestinal tolerance was good. The full 500-mL dose was rarely delivered, resulting in a low mean glutamine daily dose (22 g for burn patients and 16 g for trauma patients). In burn patients intravenous trace element delivery was superior to the enteral dose. The evolution of the Sequential Organ Failure Assessment score and other outcome variables did not differ significantly between groups. C-reactive protein decreased faster in the Gln-AOX group.
The Gln-AOX supplement was well tolerated in critically ill, injured patients, but did not improve outcome significantly. The delivery of glutamine below the 0.5-g/kg recommended dose in association with high intravenous trace element substitution doses in burn patients are likely to have blunted the impact by not reaching an efficient treatment dose. Further trials testing higher doses of Gln are required.

Keywords
Adult, Antioxidants/therapeutic use, Burns/therapy, Critical Illness/therapy, Enteral Nutrition, Female, Glutamine/therapeutic use, Humans, Male, Micronutrients/therapeutic use, Middle Aged, Multiple Organ Failure/diagnosis, Multiple Organ Failure/epidemiology, Prospective Studies, Selenium/therapeutic use, Severity of Illness Index, Treatment Outcome, Vitamin E/therapeutic use, Wounds and Injuries/therapy, Zinc/therapeutic use
Pubmed
Web of science
Create date
10/03/2009 15:07
Last modification date
20/08/2019 15:25
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