Document Detail


A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn.
MedLine Citation:
PMID:  23313017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue.
METHODS: RCTs were identified from the electronic databases: the Cochrane Library, MEDLINE, PubMed web of knowledge and hand searching journals. The trials compared the supplementation with glutamine and non-supplementation in burn. Statistical analysis was performed using RevMan5.1 software, from Cochrane Collaboration.
RESULTS: 216 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, only four RCTs, involving 155 patients, were included. For both the glutamine group and control group, total burn surface area (TBSA) (MD=2.02, 95% CI -2.17, 6.21, p=0.34) was similar. Glutamine supplementation was associated with a statistically significant decrease in the number of patients with gram-negative bacteremia (OR 0.27, 95% CI 0.08-0.92, p=0.04) and hospital mortality (OR=0.13, 95% CI 0.03, 0.51, p=0.004), however, no statistical difference was noted between groups, for the other results.
CONCLUSION: Glutamine supplemented nutrition can be associated with a reduction in mortality in hospital, complications due to gram-negative bacteremia in burn patients. Further larger and better quality trials are required, in order to determine whether any differences are statistically and clinically important.
Authors:
Jiun-Jie Lin; Xiu-Juan Chung; Chung-Yih Yang; Hui-Ling Lau
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2013-01-10
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  39     ISSN:  1879-1409     ISO Abbreviation:  Burns     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-06     Completed Date:  2013-10-17     Revised Date:  2014-01-15    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  565-70     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Burns / drug therapy*,  mortality
Critical Care / methods
Critical Illness / therapy
Dietary Supplements*
Glutamine / administration & dosage*
Hospital Mortality
Humans
Intention to Treat Analysis
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0RH81L854J/Glutamine
Comments/Corrections
Comment In:
Burns. 2013 Nov;39(7):1494-5   [PMID:  24011461 ]
Burns. 2013 Nov;39(7):1493-4   [PMID:  24011705 ]
Erratum In:
Burns. 2013 Dec;39(8):1653

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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