Glutamine supplementation to prevent morbidity and mortality in preterm infants

Royal Maternity Hospital, Neonatal Intensive Care Unit, Grosvenor Road, Belfast, Northern Ireland, UK.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2008; l(1):CD001457. DOI: 10.1002/14651858.CD001457.pub3
Source: PubMed


No evidence that supplementing preterm infants with the nutrient glutamine improves outcomes. Glutamine is an important nutrient for growth and development. Glutamine may be especially important in aiding recovery from criticalillness. This review found several well-conducted randomised controlled trails that assessed the impact of providing extra glutamine to very low birth weight infants. These trials did not find any evidence that glutamine supplementation affected the risk of death, serious infection,serious gut complications or long term development.

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    • "[48] ÓNEC no reduction on sepsis and stays in NICU Sevastiadou S et al., 2011. [50] ÓNEC Ósepsis Tubman TR et al., 2008. [49] no effect on mortality no effect on NEC, infection, time to full enteral nutrition, or duration of hospitalization Mohamad Ikram I et al., 2011. "
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    ABSTRACT: Necrotizing enterocolitis (NEC) is a critical intestinal emergency condition, which mainly occurs in preterm very low birth weight (PVLBW) infants. Despite remarkable advances in the care of PVLBW infants, with considerable improvement of the survival rate in recent decades, the incidence of NEC and NEC-related mortality have not declined accordingly. The fast progression from nonspecific signs to extensive necrosis also makes primary prevention the first priority. Recently, increasing evidence has indicated the important role of several nutrients in primary prevention of NEC. Therefore, the aim of this review is to summarize some potential immunomodulatory nutrients in the prevention of NEC, including bovine colostrum, probiotics, prebiotics (e.g., human milk oligosaccharides), long chain polyunsaturated fatty acids, and amino acids (glutamine, cysteine and N-acetylcysteine, l-arginine and l-citrulline). Based on current research evidence, probiotics are the most documented effective method to prevent NEC, while others still require further investigation in animal studies and clinical randomized controlled trials.
    Nutrients 09/2015; 7(9):7256-7270. DOI:10.3390/nu7095334 · 3.27 Impact Factor
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    • "It plays an important role as a metabolic fuel43) and also maintains the functional integrity of the gut44). A meta-analysis of 5 randomized controlled trials on the effects of glutamine supplementation on NEC showed no statistically effect on its incidence of NEC45), but a recent randomized trial reported its statistically significant reduction of NEC incidence46). "
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    ABSTRACT: Necrotizing enterocolitis (NEC) is one of the most critical morbidities in preterm infants. The incidence of NEC is 7% in very-low-birth-weight infants, and its mortality is 15 to 30%. Infants who survive NEC have various complications, such as nosocomial infection, malnutrition, growth failure, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental delays. The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity. In preterm infants with immature gastrointestinal tracts, development of NEC may be associated with a variety of factors, such as colonization with pathogenic bacteria, secondary ischemia, genetic polymorphisms conferring NEC susceptibility, anemia with red blood cell transfusion, and sensitization to cow milk proteins. To date, a variety of preventive strategies has been accepted or attempted in clinical practice with regard to the pathogenesis of NEC. These strategies include the use of breast feeding, various feeding strategies, probiotics, prebiotics, glutamine and arginine, and lactoferrin. There is substantial evidence for the efficacy of breast feeding and the use of probiotics in infants with birth weights above 1,000 g, and these strategies are commonly used in clinical practice. Other preventive strategies, however, require further research to establish their effect on NEC.
    Korean Journal of Pediatrics 09/2011; 54(9):368-72. DOI:10.3345/kjp.2011.54.9.368
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    ABSTRACT: Objective: Review the literature regarding parenteral nutrition of preterm infants in order to propose a practical guideline for indication, increase of parameters and monitor- ing of this nutritional therapy in neonatal units. Data source: Studies in English and Portuguese from the last ten years were retrieved from Medline, Embase, Lilacs and SciELO using the following key-words: preterm infants, parenteral nutrition, nutrition therapy and lipid emulsions. Also classical studies and consensus on the theme were manually searched. Data synthesis: Parenteral nutrition is an essential treatment strategy for preterm infants. Besides progress in knowledge and legislation, several factors contribute to reduce neonatal morbidity and mortality of newborns using parenteral nutrition and to increase the security in its prescription such as catheters' quality, training of the multiprofessional team and development of new specifi c parenteral nutrition formulations. Conclusions: The practical parenteral nutrition guide- line proposed here follows international guidelines and was based on critical analysis of the studies published in the last 10 years.
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