Glutamine Effects in Burn Patients

Evaluations the Effect of Parenteral Glutamine on Reducing Infection Morbidity in Burn Patients in ICU. A Randomized Controlled Double-blind Study.

The study is designed to evaluate the effect of parenteral glutamine supplementation on infection in burn patients.

Despite improvements in prevention and management, burn injury continues to represent a major threat to the health and welfare of people worldwide in all age groups. Even with early surgical intervention and aggressive antibiotic therapy, infectious complications are a major cause of death in severe burn injury, accounting for 75% of all deaths occurring after initial resuscitation.

It is proposed that one source of these infections is a translocation of gram-negative bacteria from the gut. However, this mechanism of bacterial translocation through the gut wall remains a controversial mechanism of infection in humans. In animal studies, it has been demonstrated that glutamine supplementation can decrease gut-derived bacterial translocation and improve outcomes from burn injury.

Whether this holds true in humans has to be evaluated by additional studies. A recent study concluded that glutamine supplementation reduces gram-negative bacteremia in burned patients but viewed itself as preliminary and suggested that more clinical trials are warranted to corroborate the study outcome.

Inclusion Criteria:

• Age between 18-50 years.
• Total burn surface area of 20% - 60%.
• Expected length of stay in ICU > 48 hr.
• Admission within 72 hrs of burn injury.
• Any thermal injury such as flame burns. Scald burns and contact burns.

Exclusion Criteria:

• Burn patients with hepatic failure.
• Burn patient with Severe renal failure (glomerular filtration rate (eGFR <50 ml/min).
• Patients with inborn errors of amino-acid metabolism (e.g., phenylketonuria).
• Burn patients with pre-existing severe cardiac, pulmonary diseases.
• Burn patients with diabetes mellitus or cancer.
• Patients with metabolic acidosis (pH<7.35).
• Electric burns.