| The impact of alanyl-glutamine on clinical safety, nitrogen balance, intestinal permeability, and clinical outcome in postoperative patients: a randomized, double-blind, controlled study of 120 patients. | |
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MedLine Citation:
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PMID: 10483898 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate the impact of alanyl-glutamine (Ala-Gln)-supplemented parenteral nutrition (PN) on clinical safety, nitrogen balance, intestinal permeability, and clinical outcome in postoperative patients. METHODS: One hundred twenty patients undergoing major abdominal surgery were enrolled. Protocol was approved and informed consent obtained. A double-blind protocol was designed as used in Europe. The clinical safety and outcome were observed for 60 patients in 2 centers (30 each). Sixty patients from 2 additional centers (30 each) were observed for clinical safety, nitrogen balance, intestinal permeability, and clinical outcome. All patients received isonitrogenous (0.20 g/kg body wt per day) and isocaloric (30 kcal/kg body wt per day) parenteral nutrition. The study group received Ala-Gln (Dipeptiven, Fresenius Kabi, Bad Homberg, Germany) 0.50 g/kg per day. Clinical chemistry variables, plasma amino acids profile, nitrogen balance, intestinal permeability (lactulose/mannitol ratio [L/M ratio]) were measured; hospital stay and infection rate were monitored. Statview was used for analysis of variance (ANOVA) or chi2 tests. Data were expressed as means +/- SD, and the significance level was p < .05. RESULTS: The patients in both groups were comparable prior to the operation. Vital signs and clinical chemical parameters were similar between groups. L/M ratio was 0.047+/-0.029 in control and 0.058+/-0.049 in study group before the operation (AOD-3). The L/M ratio was 0.132+/-0.081 in the control group, and 0.097+/-0.063 in study group on the seventh postoperative day. The difference of L/M ratio between groups was significant (p = .02). The cumulative nitrogen balance values were -5+/-162 mg/kg for 6 days in control and 144+/-145 mg/kg for 6 days in study group (p = .0004). All the patients recovered without incision infection. However, there were 3 cases that had infection-related complications in the control group; the difference was not significant between groups. The hospital stay in the study group was 12.5 days, which was 4 days less than that of the control group (p = .02). CONCLUSIONS: Ala-Gln-supplemented PN was clinically safe, had better nitrogen balance, and maintained intestinal permeability in postoperative patients. The clinical outcome of the patients in study group was better; it was significantly different from the control group. |
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Authors:
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Z M Jian; J D Cao; X G Zhu; W X Zhao; J C Yu; E L Ma; X R Wang; M W Zhu; H Shu; Y W Liu |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: JPEN. Journal of parenteral and enteral nutrition Volume: 23 ISSN: 0148-6071 ISO Abbreviation: JPEN J Parenter Enteral Nutr Publication Date: 1999 Sep-Oct |
Date Detail:
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Created Date: 1999-11-08 Completed Date: 1999-11-08 Revised Date: 2013-05-27 |
Medline Journal Info:
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Nlm Unique ID: 7804134 Medline TA: JPEN J Parenter Enteral Nutr Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: S62-6 Citation Subset: IM |
Affiliation:
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Peking Union Medical College Hospital, Beijing, China. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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surgery Analysis of Variance Dipeptides / therapeutic use* Double-Blind Method Female Humans Intestines / drug effects* Length of Stay Male Middle Aged Nitrogen / metabolism* Parenteral Nutrition, Total* Permeability / drug effects Postoperative Period |
| Chemical | |
Reg. No./Substance:
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0/Dipeptides; 7727-37-9/Nitrogen; U5JDO2770Z/alanylglutamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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