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Glutamine supplementation
Intravenous glutamine supplementation is standard care when parenteral nutrition is given for critical illness. There are data of a reduced mortality when glutamine supplementation is given. In addition, standard commercial products for parenteral nutrition do not contain any glutamine due to glutam...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224464/ https://www.ncbi.nlm.nih.gov/pubmed/21906372 http://dx.doi.org/10.1186/2110-5820-1-25 |
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author | Wernerman, Jan |
author_facet | Wernerman, Jan |
author_sort | Wernerman, Jan |
collection | PubMed |
description | Intravenous glutamine supplementation is standard care when parenteral nutrition is given for critical illness. There are data of a reduced mortality when glutamine supplementation is given. In addition, standard commercial products for parenteral nutrition do not contain any glutamine due to glutamine instability in aqueous solutions. For the majority of critical ill patients who are fed enterally, the available evidence is insufficient to recommend glutamine supplementation. Standard formulation of enteral nutrition contains some glutamine: 2-4 g/L. However, this dose is insufficient to normalize glutamine plasma concentration. Plasma concentration of glutamine is low in many patients with critical illness and a low level is an independent risk factor for mortality. A low plasma glutamine concentration is the best indicator of glutamine depletion. Data are emerging about how the endogenous production of glutamine is regulated. We know that skeletal muscle is the major producer of glutamine and that a part of the profound depletion of skeletal muscle seen in critical illness is a reflection of the need to produce glutamine. Glutamine is utilized in rapidly dividing cells in the splanchnic area. Quantitatively most glutamine is oxidized, but the availability of glutamine in surplus is important for the de novo synthesis of nucleotides and necessary for cell division and protein synthesis. More knowledge about the regulation of the endogenous production of glutamine is needed to outline better guidelines for glutamine supplementation in the future. |
format | Online Article Text |
id | pubmed-3224464 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Springer |
record_format | MEDLINE/PubMed |
spelling | pubmed-32244642011-12-16 Glutamine supplementation Wernerman, Jan Ann Intensive Care Review Intravenous glutamine supplementation is standard care when parenteral nutrition is given for critical illness. There are data of a reduced mortality when glutamine supplementation is given. In addition, standard commercial products for parenteral nutrition do not contain any glutamine due to glutamine instability in aqueous solutions. For the majority of critical ill patients who are fed enterally, the available evidence is insufficient to recommend glutamine supplementation. Standard formulation of enteral nutrition contains some glutamine: 2-4 g/L. However, this dose is insufficient to normalize glutamine plasma concentration. Plasma concentration of glutamine is low in many patients with critical illness and a low level is an independent risk factor for mortality. A low plasma glutamine concentration is the best indicator of glutamine depletion. Data are emerging about how the endogenous production of glutamine is regulated. We know that skeletal muscle is the major producer of glutamine and that a part of the profound depletion of skeletal muscle seen in critical illness is a reflection of the need to produce glutamine. Glutamine is utilized in rapidly dividing cells in the splanchnic area. Quantitatively most glutamine is oxidized, but the availability of glutamine in surplus is important for the de novo synthesis of nucleotides and necessary for cell division and protein synthesis. More knowledge about the regulation of the endogenous production of glutamine is needed to outline better guidelines for glutamine supplementation in the future. Springer 2011-07-18 /pmc/articles/PMC3224464/ /pubmed/21906372 http://dx.doi.org/10.1186/2110-5820-1-25 Text en Copyright ©2011 Wernerman; licensee Springer. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Wernerman, Jan Glutamine supplementation |
title | Glutamine supplementation |
title_full | Glutamine supplementation |
title_fullStr | Glutamine supplementation |
title_full_unstemmed | Glutamine supplementation |
title_short | Glutamine supplementation |
title_sort | glutamine supplementation |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224464/ https://www.ncbi.nlm.nih.gov/pubmed/21906372 http://dx.doi.org/10.1186/2110-5820-1-25 |
work_keys_str_mv | AT wernermanjan glutaminesupplementation |