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Background & Aims. Glutamine is a conditional essential amino acid that was found in reduced plasma amount in Intensive Care Unit (ICU) patients. The supplementations of glutamine and vitamin C potentially have beneficial effects on wound healing and a reduction in infection rate. In this investigation, enteral glutamine and vitamin C were provided for ICU patient, and the associated changes in proinflammatory cytokines and clinical outcomes were investigated.
Background & Aims. Glutamine is a conditional essential amino acid that was found in reduced plasma amount in Intensive Care Unit (ICU) patients. The supplementation of glutamine in ICU patients has been under much debate. Another nutritional supplement, vitamin C, had a beneficial effect on wound healing and a reduction in infection rate. In this investigation, enteral glutamine and vitamin C were provided for ICU patient, and the associated changes in proinflammatory cytokines and clinical outcomes were investigated.
Methods. This is a prospective double-blind randomized study for surgical ICU patients whom can sustain enteral feeding. The test group was provided with glutamine and vitamin C (the GA group); the control (C) group was provided with maltodextrin of equivalent calories as that provided in the GA group. Plasma glutamine, interleukin-6 (IL-6), and clinical data were collected and analyzed with biostatistical methods.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GA (glutamine and vitamin C) group | Experimental | Interventions of glutamine and vitamin C enteral supplementations were given to surgical intensive care unit (ICU) patients. Subjects in the GA group received enteral supplement of 10 g L-glutamine and 90 mg vitamin C per serving provided by Nutritec-Enjoy Nutrition Inc. (Taipei, Taiwan). |
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| Control (C) group | Placebo Comparator | Placebo: Subjects in the C group received isocaloric maltodextrin as placebo. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glutamine and vitamin C enteral supplement | Dietary Supplement | Subjects in the GA group received enteral supplement of 10 g L-glutamine and 90 mg vitamin C per serving provided by Nutritec-Enjoy Nutrition Inc. (Taipei, Taiwan). Subjects in the C group received isocaloric maltodextrin as placebo. |
| Measure | Description | Time Frame |
|---|---|---|
| Interleukin-6 | Blood samples were collected for biochemical on the starting day of enteral feeding, and every 7 days or on the day of discharge from ICU. | Blood samples were collected for biochemical analyses on the starting day of enteral feeding (day of enrollment), and every 7 days until day of discharge from ICU, or on the day of discharge from ICU, which ever is shorter, assessed up to 14 days. |
| Interleukin-10 | Blood samples were collected for biochemical on the starting day of enteral feeding, and every 7 days or on the day of discharge from ICU. | Blood samples were collected for biochemical analyses on the starting day of enteral feeding (day of enrollment), and every 7 days until day of discharge from ICU, or on the day of discharge from ICU, which ever is shorter, assessed up to 14 days. |
| Body mass index (BMI) | body height and weight were taken and body mass index (BMI) calculated at baseline. | At enrollment. |
| Acute Physiology and Chronic Health Evaluation II (APACHE II) score | APACHE II score was calculated to classify the disease severity. | At enrollment. |
| Plasma glutamine | Blood was collected for analyses of plasma glutamine levels | Blood samples were collected for biochemical analyses on the starting day of enteral feeding, and every 7 days or on the day of discharge from ICU, assessed up to 14 days. |
| Red blood cells | Blood was collected for hematological analyses | On the starting day of enteral feeding (enrollment), and every 7 days or on the day of discharge from ICU, assessed up to 14 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Length of hospital stay | Clinical outcome | Up to one year |
| Length of ICU stay | Clinical outcome | Up to one year |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D005973 | Glutamine |
| ID | Term |
|---|---|
| D024361 | Amino Acids, Basic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000599 | Amino Acids, Diamino |
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Randomized controlled trial
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This is a prospective double-blind randomized study for surgical ICU patients whom can sustain enteral feeding. The test group was provided with glutamine and vitamin C (the GA group); the control (C) group was provided with maltodextrin of equivalent calories as that provided in the GA group.
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| Hemoglobin | Blood was collected for hematological analyses | On the starting day of enteral feeding (enrollment), and every 7 days or on the day of discharge from ICU, assessed up to 14 days. |
| White blood cells | Hematological analyses | On the starting day of enteral feeding (enrollment), and every 7 days or on the day of discharge from ICU, assessed up to 14 days. |
| C reactive protein | Hematological analyses | On the starting day of enteral feeding (enrollment), and every 7 days or on the day of discharge from ICU, assessed up to 14 days. |
| Duration of ventilator use | Clinical outcome | Up to one year |
| ICU infectious complications | Clinical outcome | Up to one year |
| Mortality in ICU stay | Clinical outcome | Up to one year |
| Mortality in hospital stay | Clinical outcome | Up to one year |
| D021542 | Amino Acids, Neutral |