• Burns · Nov 2022

    Review Randomized Controlled Trial Multicenter Study

    Glutamine relieves the hypermetabolic response and reduces organ damage in severe burn patients: A multicenter, randomized controlled clinical trial.

    • Zi En Wang, Jian Jun Zheng, Jin Bin Feng, Dan Wu, Sen Su, Yong Jun Yang, Yan Wei, Zhao Hong Chen, and Xi Peng.
    • Department of Burns, Union Hospital, Fujian Medical University, Fuzhou, China; Clinical Medical Research Center, Southwest Hospital, Third Military Medical University, Army Medical University, Chongqing, China.
    • Burns. 2022 Nov 1; 48 (7): 160616171606-1617.

    BackgroundSevere burns can cause a hypermetabolic response and organ damage. Glutamine is a conditionally essential amino acid with various pharmacological effects. In this study, whether glutamine could alleviate the hypermetabolic response and maintain organ function after burn injury was analyzed.MethodsA multicenter, randomized, single-blind, parallel controlled trial was conducted to evaluate the efficacy of glutamine in decreasing hypermetabolism after burn injury. Physiological and biochemical indexes, such as vital signs, metabolic hormones, metabolic rate, and organ damage, were recorded on the 7th and 14th days after treatment.ResultsIn total, 55 adult burn patients with a total burn surface area (TBSA) of 30-70% were included in this study and randomly divided into the burn control (B, 28 patients) and burn+glutamine (B+G, 27 patients) groups. Except for the glutamine administration, the groups did not differ in the other treatments and nutrition supplements. The levels of diamine oxidase (DAO), lactulose/mannitol (L/M), β2-microglobulin, lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBD) and cardiac troponin l (cTnl) in the B+G group were significantly lower than those in the B group (p < 0.05 or 0.01). The levels of resting energy expenditure (REE), serum catecholamines, glucagon, lactate and Homeostasis model assessment (HOMA) in the B+G group were significantly lower than those in the B group (p < 0.05 or 0.01). No significant difference was found in the length of hospitalization or the mortality rate between the two groups (p > 0.05).ConclusionsGlutamine moderately alleviates the hypermetabolic response and reduces organ damage after severe burns. Therefore, the early application of glutamine, which is effective and safe, should be used as an active intervention as early as possible.Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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