The Effects of Intravenous, Enteral and Combined Administration of Glutamine on Malnutrition in Sepsis: A Randomized Clinical Trial

比較由靜脈輸入或腸道攝取或合併使用的方式補充麩醯胺酸對營養不良之敗血症病患的效果：隨機臨床試驗

Guniz Meyancı Koksal ； Emre Erbabacan ； Yusuf Tunali ； Gulsah Karaoren ； Suphi Vehid ； Huseyin Oz

《Asia Pacific Journal of Clinical Nutrition》 23卷1期 (2014/03) Pp. 34-40

https://doi.org/10.6133/apjcn.2014.23.1.11

摘要

Our aim was to compare the effects of intravenous, enteral, and enteral plus intravenous supplemented glutamine on plasma transferrin, nitrogen balance, and creatinine/height index in septic patients with malnutrition. Blood and urine samples were collected for transferrin, urea and creatinine measurements. Samples, SOFA score and protein-calorie intake values were repeated on days 7 and 15. Patients (n:120) were randomly divided into 4 groups. Group I received 30 g/day IV glutamine, group II received 30 g/day enteral glutamine, group III received 15 g/day IV and 15 g/day enteral glutamine. Group IV received only enteral feeding as a control group. Transferrin levels decreased in group IV (p＜0.01 0-7 days, p＜0.01 7-15 days, p＜0.01 0-15 days). Nitrogen balance levels were highest in group IV when compared with group I (p＜0.05, p＜0.001), group II (p＜0.001), and group III (p＜0.05, p＜0.001) on days 7-15. Creatinine/height indexes increased in group I (p＜0.001), group II (p＜0.001), group III (p＜0.001), and group IV (p＜0.05) on day 15. In group III the creatinine/height index was higher than in groups I and II (p＜0.05). In group IV, creatinine/height index was lower than in group I (p＜0.01) and group II (p＜0.001). Protein-calorie intake in group IV was higher than others on day 7 (p＜0.05). SOFA scores of group IV were higher than the other groups on day 15 (p＜0.05). This study demonstrated, that combined route of gln supplementation resulted in the most positive outcome to transferrin, creatine/height index and nitrogen balance (on days 7 and 15) during the catabolic phase of septic patients with malnutrition.

關鍵字

營養不良 ； 麩醯胺酸 ； 敗血症 ； 運鐵蛋白 ； 氮平衡

並列摘要

Our aim was to compare the effects of intravenous, enteral, and enteral plus intravenous supplemented glutamine on plasma transferrin, nitrogen balance, and creatinine/height index in septic patients with malnutrition. Blood and urine samples were collected for transferrin, urea and creatinine measurements. Samples, SOFA score and protein-calorie intake values were repeated on days 7 and 15. Patients (n:120) were randomly divided into 4 groups. Group I received 30 g/day IV glutamine, group II received 30 g/day enteral glutamine, group III received 15 g/day IV and 15 g/day enteral glutamine. Group IV received only enteral feeding as a control group. Transferrin levels decreased in group IV (p＜0.01 0-7 days, p＜0.01 7-15 days, p＜0.01 0-15 days). Nitrogen balance levels were highest in group IV when compared with group I (p＜0.05, p＜0.001), group II (p＜0.001), and group III (p＜0.05, p＜0.001) on days 7-15. Creatinine/height indexes increased in group I (p＜0.001), group II (p＜0.001), group III (p＜0.001), and group IV (p＜0.05) on day 15. In group III the creatinine/height index was higher than in groups I and II (p＜0.05). In group IV, creatinine/height index was lower than in group I (p＜0.01) and group II (p＜0.001). Protein-calorie intake in group IV was higher than others on day 7 (p＜0.05). SOFA scores of group IV were higher than the other groups on day 15 (p＜0.05). This study demonstrated, that combined route of gln supplementation resulted in the most positive outcome to transferrin, creatine/height index and nitrogen balance (on days 7 and 15) during the catabolic phase of septic patients with malnutrition.

並列關鍵字

malnutrition ； glutamine ； sepsis ； transferring ； nitrogen balance

參考文獻

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