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

t more research should be done because the average glutamine levels weren't especially low in this study, and she suggested that the dose of replacement glutamine given might have been too high, or it might have been given too early in the course of the illness.

Overall, she said, this study shows that glutamine may have the potential to cause harm. "I think this study, given its power and quality and showing a substantial rise in the risk of death with the treatment, strongly advises against infusing glutamine in severely ill patients with multiple organ failure in the ICU. The outcome of this study forms a solid basis for changing clinical practice guidelines," she said.

Heyland's study included 1,223 critically ill patients treated in 40 intensive care units in Canada, the United States and Europe. All of the patients had multi-organ failure and were on mechanical ventilation to breathe.

The patients were randomly assigned to receive glutamine, antioxidants, both or a placebo treatment within 24 hours of admission to the intensive care unit.

The results showed a "trend" in the association between receiving glutamine and a higher death rate. Thirty-two percent of those who received glutamine died within 28 days, compared with 27 percent of those who weren't given glutamine. The risk of dying if given glutamine was 28 percent higher than for patients who weren't given glutamine.

In a stronger finding deemed statistically significant, in-hospital deaths and deaths within six months were also higher for those given glutamine, according to the study.

Heyland said it's important to note that this study's finding only apply to the critically ill patients with multi-organ failure. Glutamine is often used beneficially in patients who aren't so sick, he said.

"Overall, there was no suggestion that glutamine supplementation was harmful until this report," said Dr. Rafael Barrera, director of the surgical intensive care unit at
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