Document Detail


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.
MedLine Citation:
PMID:  10483898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  1999-11-08     Completed Date:  1999-11-08     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S62-6     Citation Subset:  IM    
Affiliation:
Peking Union Medical College Hospital, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / 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:
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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