Glutamine effects on heat shock protein 70 and interleukines 6 and 10: Randomized trial of glutamine supplementation versus standard parenteral nutrition in critically ill children. Issue 1 (February 2016)

• Record Type: Journal Article
• Authors: Jordan, Iolanda; Balaguer, Mònica; Esteban, M.Esther; Cambra, Francisco José; Felipe, Aida; Hernández, Lluïsa; Alsina, Laia; Molero, Marta; Villaronga, Miquel; Esteban, Elisabeth
• Is Part Of: Clinical nutrition. Volume 35:Issue 1(2016:Feb.)
• Page Start: 34
• Page End: 40
• Publication Date: 2016-02
• Subjects: Glutamine -- HSP-70 -- Inflammatory mediators -- Parenteral nutrition -- Pediatric intensive care unit; Gln glutamine -- HSP-70 heat shock protein 70 -- IL-6 interleukine 6 -- IL-10 interleukine 10 -- PICU pediatric intensive care unit -- PRISM-II pediatric risk of mortality II -- SPN standard parenteral nutrition; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2015.01.019
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: To determine whether glutamine (Gln) supplementation would have a role modifying both the oxidative stress and the inflammatory response of critically ill children. Methods: Prospective, randomized, double-blind, interventional clinical trial. Selection criteria were children requiring parenteral nutrition for at least 5 days diagnosed with severe sepsis or post major surgery. Patients were randomly assigned to standard parenteral nutrition (SPN, 49 subjects) or standard parenteral nutrition with glutamine supplementation (SPN + Gln, 49 subjects). Results: Glutamine levels failed to show statistical differences between groups. At day 5, patients in the SPN + Gln group had significantly higher levels of HSP-70 (heat shock protein 70) as compared with the SPN group (68.6 vs 5.4, p = 0.014). In both groups, IL-6 (interleukine 6) levels showed a remarkable descent from baseline and day 2 (SPN: 42.24 vs 9.39, p < 0.001; SPN + Gln: 35.20 vs 13.80, p < 0.001) but only the treatment group showed a statistically significant decrease between day 2 and day 5 (13.80 vs 10.55, p = 0.013). Levels of IL-10 (interleukine 10) did not vary among visits except in the SPN between baseline and day 2 (9.55 vs 5.356, p < 0.001). At the end of the study, no significant differences between groups for PICU and hospital stay were observed. No adverse events were detected in any group. Conclusions: Glutamine supplementation in critically-ill children contributed to maintain high HSP-70 levels for longer. Glutamine supplementation had no influence on IL-10 and failed to show a significant reduction of IL-6 levels.