Document Detail

Glutamine supplementation to prevent morbidity and mortality in preterm infants.
MedLine Citation:
PMID:  22419279     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Glutamine is a conditionally essential amino acid. Endogenous biosynthesis may be insufficient for tissue needs in states of metabolic stress. Evidence exists that glutamine supplementation improves clinical outcomes in critically ill adults. It has been suggested that glutamine supplementation may also benefit preterm infants.
OBJECTIVES: To determine the effects of glutamine supplementation on mortality and morbidity in preterm infants.
SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2011, Issue 4), MEDLINE, EMBASE and CINAHL (to November 2011), conference proceedings and previous reviews.
SELECTION CRITERIA: Randomised or quasi-randomised controlled trials that compared glutamine supplementation versus no glutamine supplementation in preterm infants at any time from birth to discharge from hospital.
DATA COLLECTION AND ANALYSIS: We extracted data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two review authors. We synthesised data using a fixed-effect model and reported typical relative risk, typical risk difference and weighted mean difference.
MAIN RESULTS: We identified 11 randomised controlled trials in which a total of 2771 preterm infants participated. Five trials assessed enteral glutamine supplementation and six trials assessed parenteral glutamine supplementation. The trials were generally of good methodological quality. Meta-analysis did not detect a statistically significant effect of glutamine supplementation on mortality [typical relative risk 0.98 (95% confidence interval 0.80 to 1.18); risk difference 0.00 (95% confidence interval -0.03 to 0.02)] or major neonatal morbidities including the incidence of invasive infection or necrotising enterocolitis. Two trials that assessed neurodevelopmental outcomes at 18 to 24 months did not find any statistically significant differences in various assessments.
AUTHORS' CONCLUSIONS: The available trial data do not provide evidence that glutamine supplementation confers important benefits for preterm infants.
Thirimon Moe-Byrne; Jennifer V E Wagner; William McGuire
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2012-03-14
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  3     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2012  
Date Detail:
Created Date:  2012-03-15     Completed Date:  2012-06-07     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD001457     Citation Subset:  IM    
Centre for Reviews and Dissemination, University of York, York, UK.
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MeSH Terms
Dietary Supplements*
Glutamine / administration & dosage*
Infant Mortality*
Infant Nutritional Physiological Phenomena*
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight
Randomized Controlled Trials as Topic
Reg. No./Substance:
Update Of:
Cochrane Database Syst Rev. 2008;(1):CD001457   [PMID:  18253992 ]

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