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Nutrient Therapy Won't Help ICU Patients: Study
Date:4/17/2013

By Serena Gordon
HealthDay Reporter

WEDNESDAY, April 17 (HealthDay News) -- Replenishing certain nutrients in critically ill patients may not be the best therapy for them, new research suggests.

Giving supplements of the amino acid glutamine in intravenous fluids was linked to a nearly 30 percent increase in the risk of death, according to the study. The researchers also found that replacing antioxidants didn't appear to lower the risk of death or organ failure.

"When you get sick, your body has [internal] mechanisms to help you get better. Levels of glutamine and antioxidants get depleted, and we thought giving them back would be beneficial. So, we picked the sickest patients -- critically ill patients with multi-organ failure -- and gave them back high doses," explained study author Dr. Daren Heyland, a professor of medicine at Queens University in Kingston, Ontario.

"We were totally surprised to find that glutamine was harmful. There was no prior indication in the literature that it could be harmful. Antioxidants were neutral. They weren't positive or negative. It's likely that we gave too little antioxidants and [didn't give them quickly enough]," Heyland said.

As to why glutamine was linked to an increased risk of death, Heyland said the researchers aren't sure how that happened. "Perhaps the changes that occur because of sickness are adaptive rather than maladaptive," he said.

Results of the study appear in the April 18 issue of the New England Journal of Medicine.

The author of an accompanying editorial, Dr. Greet Van den Berghe, head of intensive care medicine at University Hospitals Leuven, in Belgium, agreed that low glutamine levels may be an adaptive response.

"If patients show low glutamine levels acutely in response to severe illness, it certainly looks like one should not correct this with the dose used in this study," Van den Berghe said.

But, she added tha
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