Abstract
Glutamine is one of the conditionally essential free amino acids with multiple biological functions. Its supplementation to parenteral nutrition has been widely used for the management of complications in intensive care. However, controversial clinical reports have generated reluctance in the use of this pharmaco-nutrient. In this commentary, we address the impact of four studies that influenced the recommendations on glutamine supplementation by the Canadian Clinical Practice Guide 2015. Because of the importance of this guideline in clinical practice, we strongly believe that a more rigorous and critical evaluation is required to support recommendations in future guidelines.
Highlights
Glutamine is one of the conditionally essential free amino acids with multiple biological functions
It has been reported that high Gln levels are caused by acute liver failure [5] and that in kidney disease the amino acid (AA) clearance is affected, increasing its plasmatic levels
Controversy has emerged after the publication of the REDOX (Reducing Deaths due to Oxidative Stress) study [8], causing distrust and fear in the use of this supplement
Summary
Glutamine is one of the conditionally essential free amino acids with multiple biological functions. Gln depletion is an independent predictor of mortality in intensive care unit (ICU) patients [2, 3]. Rodas et al [4] showed, in a small observational study, that low (930 μmol/l) plasma concentrations of Gln in ICU patients are independent risk factors for mortality.
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