comparative study of the effect of parentral and oral glutamine on biochemical parameters and on the duration of ICU stay in critically ill patients

ABSTRACT

To study the comparative effects of parenteral and oral glutamine therapy on biochemical parameters and reduction in the hospital stay of critically ill patients. Randomized controlled trial. 120 critically ill patients aged 16-60 years admitted to Trauma Ventilatory Unit, Trauma centre King George Medical University, Lucknow. The patients were randomly divided into 3 equal groups, 40 in each group Group A [control group] received no glutamine; Group B received oral glutamine 20 g/d for 5 days and Group C received l-alanyl-l-glutamine dipeptide 0.3 g/kg/d by intravenous infusion for 5 days. Complete blood count was done at regular intervals of 24 hours. Total proteins and serum albumin were recorded at 5 day intervals. Single blinding was done. The total leukocyte counts [TLC] levels in all the three groups increased after the treatment and the observed increase was least evident in Group C [18.7%], followed by Group B [32.5%] and it was the highest in Group A [38.2%]. A similar observation was made for CRP and lymphocyte levels in all of the three groups. However, a significant decrease was found in total protein and albumin levels. The mean duration of hospital stay of Group C was the least followed by Group B and Group A. Parenteral glutamine in a dose of 0.3 g/kg/d was more efficacious than 20 g/d oral glutamine in increasing/decreasing in the biochemical parameters after the therapy. The duration of hospital stay was similar in all the groups after treatment