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L-Glutamine for Acute Pancreatitis.

Forty-four patients (mean age, 43 years) with severe acute pancreatitis acute pancreatitis Inflammation of the pancreas of abrupt onset, often with gallstones and alcohol ingestion Epidemiology 109,000 hospitalizations, 2251 deaths–US; 10-fold ↑ from 1960s to 1980s–reason unclear;  (two-thirds of cases due to biliary disease, 23% due to alcohol) were randomly assigned to receive, beginning after hospital admission, standard parenteral nutrition (control group) or an isonitrogenous, isocaloric parenteral nutrition formula that supplied L-glutamine in the form of L-alanyl-L-glutamine (0.4 g per kg of body weight per day). The number of patients who developed infections was significantly lower in the L-glutamine group than in the control group (41% vs. 73%; p = 0.03). The mortality rate was nonsignificantly lower in the L-glutamine group than in the control group (9% vs. 23%; p = 0.20). Nitrogen balance, serum albumin, and certain measures of immune function were significantly better in the L-glutamine group than in the control group.

Comment: While glutamine glutamine (gl`təmēn), organic compound, one of the 20 amino acids commonly found in animal proteins.  is considered a nonessential amino acid nonessential amino acid
n.
An alpha-amino acid that is required for protein synthesis and can be synthesized by humans.
, additional amounts are needed under conditions of extreme stress, in order to support gastrointestinal and immune function. The results of the present study indicate that the addition of L-glutamine to parenteral nutrition decreased the number of infections and possibly decreased mortality, when compared with standard parenteral nutrition, in patients with severe acute pancreatitis. L-glutamine has been reported to produce similar benefits in other critically ill patients. For parenteral nutrition, L-glutamine is frequently given in the form of L-alanyl-L-glutamine, because of its greater stability.

Fuentes-Orozco C et al. L-Alanyl-L-glutamine-supplemented parenteral nutrition decreases infectious morbidity rate in patients with severe acute pancreatitis. |PEN| Parenter Enteral enteral /en·ter·al/ (en´ter'l) enteric.

en·ter·al
adj.
1. Within or by way of the intestine, as distinguished from parenteral.

2. Enteric.
 Nutr. 2008;32:403-411.

by Alan R. Gaby, MD

drgaby@earthlink.net
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Publication:Townsend Letter
Article Type:Brief article
Geographic Code:1USA
Date:Jun 1, 2009
Words:252
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