Original Article

European Journal of Clinical Nutrition (2008) 62, 575–583; doi:10.1038/sj.ejcn.1602754; published online 18 April 2007

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

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.

A Culkin1,5, S M Gabe2, I Bjarnason3, G Grimble4,5, A M Madden5 and A Forbes2,6

  1. 1Department of Nutrition and Dietetics, St Mark's Hospital, Harrow, Middlesex, UK
  2. 2Department of Gastroenterology, St Mark's Hospital, Harrow, Middlesex, UK
  3. 3Department of Clinical Biochemistry, King's College Hospital, London, UK
  4. 4Department of Clinical Nutrition, School of Life Sciences, University of Surrey, Roehampton, UK
  5. 5Department of Health and Human Sciences, London Metropolitan University, London, UK
  6. 6Department of Gastroenterology and Nutrition, University College Hospital, London, UK

Correspondence: A Culkin, Department of Nutrition and Dietetics, Northwick Park and St Mark's NHS Trust, Watford Road, Harrow, Middlesex, HA1 3UJ, UK. E-mail: alison.culkin@nwlh.nhs.uk

Received 25 May 2006; Revised 5 March 2007; Accepted 8 March 2007; Published online 18 April 2007.

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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.

Keywords:

glutamine, home parenteral nutrition, infective complications, intestinal permeability, TPN

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