Glutamine supplementation to prevent morbidity and mortality in preterm infants

Moe-Byrne T, Wagner JVE, McGuire W

Published Online:

March 14, 2012

Glutamine is an important nutrient for growth and development and may be especially important in aiding recovery from critical illness. This review included several well-conducted randomised controlled trials that assessed the impact of providing extra glutamine to preterm infants. These trials did not find strong evidence that glutamine supplementation affected the risk of death, serious infection or bowel disease, or longer term development.

Abstract (click to read)

Background:

Glutamine is a conditionally essential amino acid. Endogenous biosynthesis may be insufficient for tissue needs in states of metabolic stress. Evidence exists that glutamine supplementation improves clinical outcomes in critically ill adults. It has been suggested that glutamine supplementation may also benefit preterm infants.

Objectives:

To determine the effects of glutamine supplementation on mortality and morbidity in preterm infants.

Search strategy:

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, 2011, Issue 4), 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 preterm infants at any time from birth to discharge from hospital.

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 relative risk, typical risk difference and weighted mean difference.

Main results:

We identified 11 randomised controlled trials in which a total of 2771 preterm infants participated. Five trials assessed enteral glutamine supplementation and six trials assessed parenteral glutamine supplementation. The trials were generally of good methodological quality. Meta-analysis did not detect a statistically significant effect of glutamine supplementation on mortality [typical relative risk 0.98 (95% confidence interval 0.80 to 1.18); risk difference 0.00 (95% confidence interval -0.03 to 0.02)] or major neonatal morbidities including the incidence of invasive infection or necrotising enterocolitis. Two trials that assessed neurodevelopmental outcomes at 18 to 24 months did not find any statistically significant differences in various assessments.

Authors' conclusions:

The available trial data do not provide evidence that glutamine supplementation confers important benefits for preterm infants.

This record should be cited as:

Moe-Byrne T, Wagner JVE, McGuire W. Glutamine supplementation to prevent morbidity and mortality in preterm infants. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD001457. DOI: 10.1002/14651858.CD001457.pub4

Assessed as up to date:

November 30, 2011

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Neonatal Group

Health topics:

Complementary & alternative medicine > Neonatal care > Parenteral feeding

Neonatal care > Parenteral feeding

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Glutamine supplementation to prevent morbidity and mortality in preterm infants

More like this

Copyright © 2012 - The Cochrane Collaboration