Wischmeyer PE
Nutrition in clinical practice : official publication of the American Society for Parenteral an.... Date of publication 2019 Oct 1;volume 34(5):681-687.
1. Nutr Clin Pract. 2019 Oct;34(5):681-687. doi: 10.1002/ncp.10362. Epub 2019 Jul 3.
Glutamine in Burn Injury.
Wischmeyer PE(1).
Author information:
(1)Department of Anesthesiology and Duke Clinical Research Institute, Duke
University Hospital, Durham, North Carolina, USA.
Burn injury is the most devastating of survivable injuries and is a worldwide
public health crisis. Burn injury is among the most severe metabolic stresses a
patient can sustain. A major burn leads to an inflammatory response and
catabolism that, when compounded by burn wound nutrient losses, can lead to
severe nutrition losses and deficiencies. These losses can impair immune function
and wound healing and place burn patients at high risk for organ injury and
mortality. Experimental data indicate glutamine (GLN) is well positioned
mechanistically, perhaps above and beyond in any other intensive care unit
setting, to improve outcome in burn-injured patients. Initial clinical trial data
have also shown a consistent signal of reduced mortality and reduced hospital
length of stay in burn-injured subjects, without signals of clinical risk. A
number of GLN clinical trials demonstrate significant reductions of gram-negative
bacteremia in burn injury, perhaps via maintenance of the gut barrier or gut
immune function. Current societal recommendations continue to suggest the use of
GLN in burn injury. The promising clinical data in burn-injured patients, with no
signals of harm, have warranted study of GLN in the definitive RE-ENERGIZE trial,
which is now ongoing.
© 2019 American Society for Parenteral and Enteral Nutrition.
DOI: 10.1002/ncp.10362
PMID: 31270877 [Indexed for MEDLINE]
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