Glutamine, Antioxidants No Benefit to Critically Ill Patients
Glutamine linked to increase in 28-day mortality among critically ill adults with multiorgan failure
WEDNESDAY, April 17 (HealthDay News) -- For critically ill patients with multiorgan failure, early supplementation with glutamine or antioxidants does not improve clinical outcomes, according to a study published in the April 18 issue of the New England Journal of Medicine.
Daren Heyland, M.D., from Kingston General Hospital in Canada, and colleagues randomly assigned 1,223 critically ill adults in 40 intensive care units (ICUs) in Canada, the United States, and Europe to receive supplements of glutamine, antioxidants, both, or placebo. Patients had multiorgan failure and were receiving mechanical ventilation. Supplementation began within 24 hours of ICU admission and was provided both intravenously and enterally.
The researchers found that among patients who received glutamine there was a trend toward increased mortality at 28 days (32.4 versus 27.2 percent; adjusted odds ratio, 1.28; P = 0.05). For those who received glutamine, in-hospital mortality and mortality at six months were significantly higher. The rates of organ failure and infectious complications were not affected by glutamine. Antioxidant supplementation had no impact on 28-day mortality or on any secondary end points. The groups did not differ with respect to serious adverse events.
"In conclusion, this trial showed that the early administration of glutamine in critically ill patients with multiorgan failure was harmful," write the authors. "We also conclude that antioxidant supplementation as provided in this trial conferred no therapeutic benefit."