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  • Original Article
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A double-blind, randomized, controlled crossover trial of glutamine supplementation in home parenteral nutrition

European Journal of Clinical Nutrition volume 62, pages 575–583 (2008)Cite this article

Abstract

Objective:

Studies suggest clinical benefit of glutamine-supplemented parenteral nutrition. The aim was to determine if the inclusion of 10 g of glutamine as part of the nitrogen source of home parenteral nutrition (HPN) reduces infectious complications.

Subjects/Methods:

Thirty-five patients on HPN were recruited and 22 completed the study. Patients were randomized to receive either standard HPN or glutamine-supplemented HPN. Patients were assessed at randomization, 3 and 6 months later then they were crossed over to the alternative HPN and reassessed at 3 and 6 months. Assessments included plasma amino acid concentrations, intestinal permeability and absorption, nutritional status, oral and parenteral intake, quality of life, routine biochemistry and haematology.

Results:

No difference was seen between the groups at randomization. No difference was detected between the treatment phases for infective complications (55% in the standard treatment phase and 36% in the glutamine-supplemented phase P=0.67). There were no differences in nutritional status, intestinal permeability, plasma glutamine concentrations or quality of life.

Conclusion:

Although limited by the sample size, the study has shown that glutamine as part of the nitrogen source of parenteral nutrition can be given to patients on HPN for 6 months without any adverse effects.

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Acknowledgements

Financial support of this investigation in the form of an unrestricted grant from Fresenius Kabi is gratefully acknowledged. Claire Chadwick and Shola Olusanya, Department of Pharmacy at St Mark's, are thanked for performing the randomization and crossover. We are grateful to Roy Sherwood, Sue Maestranzi and Kate John from King's College Hospital for the amino acid and urinary sugar analyses and to Diane Brundrett for dietetic support. Paul Bassett is thanked for help with statistical analysis.

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Authors and Affiliations

  1. Department of Nutrition and Dietetics, St Mark's Hospital, Harrow, Middlesex, UK

    A Culkin

  2. Department of Gastroenterology, St Mark's Hospital, Harrow, Middlesex, UK

    S M Gabe & A Forbes

  3. Department of Clinical Biochemistry, King's College Hospital, London, UK

    I Bjarnason

  4. Department of Clinical Nutrition, School of Life Sciences, University of Surrey, Roehampton, UK

    G Grimble

  5. Department of Health and Human Sciences, London Metropolitan University, London, UK

    A Culkin, G Grimble & A M Madden

  6. Department of Gastroenterology and Nutrition, University College Hospital, London, UK

    A Forbes

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  1. A Culkin
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  2. S M Gabe
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  3. I Bjarnason
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  4. G Grimble
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  6. A Forbes
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Corresponding author

Correspondence to A Culkin.

Additional information

Contributors: AC was the study lead and involved in recruitment, data collection, blood and urine sample collection and preparation, data interpretation and writing the article. SMG was involved in the protocol development, supervision of the data collection and interpretation and writing the article. IB and GG were involved in the protocol development. AF was involved in the protocol development and writing the article. AMM was involved in writing the article.

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Culkin, A., Gabe, S., Bjarnason, I. et al. A double-blind, randomized, controlled crossover trial of glutamine supplementation in home parenteral nutrition. Eur J Clin Nutr 62, 575–583 (2008). https://doi.org/10.1038/sj.ejcn.1602754

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602754

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