• Abelardo García-de-Lorenzo, Antonio Zarazaga, Pedro Pablo García-Luna, Ferrán Gonzalez-Huix, Jorge López-Martínez, Alberto Miján, Luis Quecedo, César Casimiro, Luis Usán, and Juan del Llano.
• Department of Intensive Medicine, Madrid, Spain. agdl@servitel.es
• Nutrition. 2003 Sep 1; 19 (9): 805-11.

ObjectiveThe purpose of this systematic review was to locate and assess the quality of scientific evidence to establish a graded recommendation based on the effectiveness of glutamine-enriched enteral nutrition in different medical and surgical conditions. We were concerned with the following topics: 1) benefits of enteral administration of glutamine in different pathologic conditions, and 2) dose, duration, and time of initiation of glutamine-enriched diets.MethodsThe sources consulted for the search were MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Healthstar and HSTAT. Ninety-one studies were assessed; after a methodologic review (primary review), only 16 studies met the inclusion criteria for analysis by a group of experts (secondary review). The coordinators supervised all data, and a final consensus was reached among the coordinators, experts, and methodologists.Results And ConclusionsGlutamine-enriched diets showed good overall tolerance, improvement of immunologic aspects in multiple trauma patients, cost reduction in critically ill patients, and improvement of mucositis in post-chemotherapy patients (grade B recommendations). The doses given and the duration of therapy varied widely depending on the pathologic condition. Intake of 20 to 30 g/d, early initiation of diet, and maintenance for 5 d or longer are recommended (grade C recommendations).

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