Document Detail

Oral glutamine in addition to parenteral nutrition improves mortality and the healing of high-output intestinal fistulas.
MedLine Citation:
PMID:  18051993     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Anastomotic leakage is one of the most important causes of morbidity and mortality in gastrointestinal surgery. We investigated the effect of oral glutamine on the healing of high-output intestinal fistula.
SETTING: A tertiary Universitary Hospital of the University of Mato Grosso, Cuiaba, Brazil.
PATIENTS AND METHODS: 28 patients (25 males and 3 females; median age = 45 [18-71] years old) admitted with high output post-operative small bowel fistulas (median volume in 24 h: 850 [600-2,200] mL) during a 4 years period were retrospectively studied.
INTERVENTIONS: In the first two years 19 (67.9%) patients received only TPN as the initial nutritional support. In the last two years however, due to a change in the protocol for the nutritional support in cases of intestinal fistula 9 patients (32.1%) received oral glutamine (0.3 g/kg/day; 150 mL/day) in addition to TPN. Endpoints of the study were mortality, resolution of the fistula, and length of hospital stay (LOS).
RESULTS: The overall mortality was 46.4% (13 patients). Fistula closure was observed in all other 15 patients (53.6%) that survived. In the subset of survived patients LOS was similar in those who received or not received glutamine. The multivariate regression analysis showed that resolution of the fistula was 13 times greater in patients that received oral glutamine (OR = 13.2 (95% CI = 1.1-160.5); p = 0.04) and 15 times greater in non-malnourished patients (OR = 15.4 [95% CI = 1.1-215.5]; p = 0.04).
CONCLUSIONS: We conclude that oral glutamine accelerated the healing and diminished the mortality in this series of patients with post-operative high-output intestinal fistula receiving TPN.
J E de Aguilar-Nascimento; C Caporossi; D Borges Dock-Nascimento; I S de Arruda; K Moreno; W Moreno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nutrición hospitalaria     Volume:  22     ISSN:  0212-1611     ISO Abbreviation:  Nutr Hosp     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-03-17     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9100365     Medline TA:  Nutr Hosp     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  672-6     Citation Subset:  IM    
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MeSH Terms
Administration, Oral
Combined Modality Therapy
Glutamine / administration & dosage*
Intestinal Fistula / mortality*,  therapy*
Middle Aged
Parenteral Nutrition*
Retrospective Studies
Reg. No./Substance:

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