Role of Glutamine Supplementation in Critically ill patients: A Narrative Review

Enteral nutrition has been known to bring about reduction in infectious complications in post major abdominal
surgery. Previous systematic reviews and meta-analysis have suggested that immune nutrition in critically ill
have been associated with reduced hospital stay, infection rate and inflammatory response. Glutamine is
considered an essential amino acid during stress and critical illness. Parenteral glutamine supplementation in
critically ill patients has been shown to improve survival rate and minimise infectious complications, costs and
hospital length-of-stay. The purpose of this article is to provide a narrativereview of the current evidence and
trials of enteral and parenteral glutamine supplementation in multipletrauma patients. A search in PubMed and
EMBASE was conducted and relevant papers that investigated the effect of enteral or parenteral glutamine
supplementation in patients with multiple trauma were reviewed. Although recent nutritional guidelines
recommend that glutamine supplementation should be considered in these patients, further well-designed trials
are required to provide a confirmed conclusion. Due to the inconclusive results of enteral glutamine supplementation trials in patients receiving enteral nutrition, future trials should focus on intravenous glutamine supplementation in patients requiring enteral nutrition and on major clinical outcome measures (e.g. mortality
rate, infectious complications).