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Intervention Review

Glutamine supplementation for young infants with severe gastrointestinal disease

  1. Jennifer VE Wagner1,
  2. Thirimon Moe-Byrne1,
  3. Zubin Grover2,
  4. William McGuire3,*

Editorial Group: Cochrane Neonatal Group

Published Online: 11 JUL 2012

Assessed as up-to-date: 5 DEC 2011

DOI: 10.1002/14651858.CD005947.pub3


How to Cite

Wagner JVE, Moe-Byrne T, Grover Z, McGuire W. Glutamine supplementation for young infants with severe gastrointestinal disease. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD005947. DOI: 10.1002/14651858.CD005947.pub3.

Author Information

  1. 1

    Centre for Reviews and Dissemination, University of York, York, UK

  2. 2

    Royal Children's Hospital, Department of Gastroenterology, Brisbane, Australia

  3. 3

    Hull York Medical School & Centre for Reviews and Dissemination, University of York, York, Y010 5DD, UK

*William McGuire, Hull York Medical School & Centre for Reviews and Dissemination, University of York, York, Y010 5DD, UK. William.McGuire@hyms.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 11 JUL 2012

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This is not the most recent version of the article. View current version (15 DEC 2014)

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

Endogenous glutamine biosynthesis may be insufficient to meet the needs of people with severe gastrointestinal disease. Studies using experimental animal models and controlled trials in adult patients with severe gastrointestinal disease have suggested that glutamine supplementation improves clinical outcomes. This review examines evidence for the effect of glutamine supplementation in young infants with severe gastrointestinal disease.

Objectives

To assess the evidence from randomised controlled trials that providing supplemental glutamine reduces mortality and morbidity in young infants with severe gastrointestinal disease.

Search methods

We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2012, Issue 1), MEDLINE, EMBASE, and CINAHL (to November 2011), conference proceedings, and previous reviews.

Selection criteria

Randomised or quasi-randomised controlled trials that compared glutamine supplementation versus no glutamine supplementation in infants up to three months old (corrected for preterm birth if necessary) with severe gastrointestinal disease defined as a congenital or acquired gastrointestinal condition that is likely to necessitate providing parenteral nutrition for at least 24 hours.

Data collection and analysis

We extracted data using the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors. We synthesised data using a fixed-effect model and reported typical risk ratio (RR), typical risk difference (RD), and weighted mean difference (WMD).

Main results

We found two trials in which a total of 100 infants participated. The trials were of good methodological quality but were too small to detect clinically important effects of glutamine supplementation. Meta-analysis did not reveal a statistically significant difference in the risk of death before hospital discharge (typical RR 1.57; 95% confidence interval (95% CI) 0.25 to 9.66; RD 0.02; 95% CI -0.06 to 0.10) or in the rate of invasive infection [typical RR 1.22; 95% CI 0.55 to 2.70; RD 0.04; 95% CI -0.12 to 0.20).

Authors' conclusions

The available data from randomised controlled trials are insufficient to determine whether glutamine supplementation has any important benefits for young infants with severe gastrointestinal disease.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Glutamine supplementation for young infants with severe gastrointestinal disease

Currently, there is insufficient evidence to determine whether giving young infants with severe gastrointestinal problems supplemental glutamine is beneficial. Glutamine is an amino acid that helps tissues, particularly in the gastrointestinal tract, recover from damage. We looked for evidence that giving extra glutamine to young infants with severe bowel problems helps them to recover faster and more fully. At present, data are only available from two small trials and these are insufficient to determine whether glutamine supplements are beneficial or harmful.