Abstract
The prospective clinical study was performed to determine the benefit of early enteral feeding with glutamine in cases of critically ill patients in the acute catabolic stage. Twenty-one patients in an ICU were randomly divided into three groups, patients in Control group (n=7) received only enteral feeding, Group I (n=7) received enteral feeding with 0.2g/kg SBW (standard body weight) glutamine, and in Group II (n=7) patients received enteral feeding with 0.5g/kg SBW glutamine for ten days. The total calorie and nitrogen content of enteral feeding in these three groups was prepared to have the same volume and dose. The APACHE-II scores among the three groups were not significantly different. The change of serum proteins (total protein, albumin, pre-albumin, retinol binding protein, transferrin) during a ten day period was not significantly different. However, the change of 3-methylhistidine (3-MH) in the urine during the 10 days was significantly decreased in Group I and in Group II compared to the Control group (Control group: 0.06±0.05mEq/gCr; Group I: -0.03±0.03, p<0.05; Group II: -0.04±0.03, p<0.05). The nitrogen balance on Day 10 was significantly higher in Group I and in Group II than in the Control group (Control group: -10.1±2.7g/day; Group I: -3.0±2.0, p<0.05; Group II: -1.6±1.1, p<0.01). The infectious complication rate of Group II was lower than in the Control group, but it was not significant. The incidence of diarrhea, the degree of organ function disorders (liver and kidney), and the prognosis in Group I and Group II were not significantly different compared with the Control group. These results indicate that early enteral feeding with glutamine improved nitrogen balance and catabolic metabolisms for critical ill patients in ICU without causing any other complications.
