Статья

Parenteral Glutamine Supplementation Does Not Reduce the Risk of Mortality or Late-Onset Sepsis in Extremely Low Birth Weight Infants

Brenda B. PoindexterDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, IndianaRichard A. EhrenkranzDepartment of Pediatrics, Yale University School of Medicine, New Haven, ConnecticutBarbara J. StollDepartment of Pediatrics, Emory University School of Medicine, Atlanta, GeorgiaLinda L. WrightNational Institute of Child Health and Human Development, Bethesda, MarylandW. Kenneth PooleResearch Triangle Institute, Research Triangle Park, North CarolinaWilliam OhDepartment of Pediatrics, Brown University, Providence, Rhode IslandCharles R. BauerDepartment of Pediatrics, University of Miami, Miami, FloridaL.A. PapileDepartment of Pediatrics, University of New Mexico School of Medicine, Albuquerque, New MexicoJon E. TysonCenter for Clinical Research and Evidence Based Medicine, University of Texas Health Science Center at Houston Medical School, Houston, TexasWaldemar A. CarloDepartment of Pediatrics, University of Alabama, Birmingham, AlabamaAbbot R. LaptookDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TexasVivek NarendranDepartment of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OhioDavid K. StevensonDivision of Neonatology, Stanford University Medical Center, Palo Alto, CaliforniaAvroy A. FanaroffDepartment of Pediatrics, Case Western Reserve University, Cleveland, OhioSheldon B. KoronesThe Newborn Center, University of Tennessee, Memphis, TennesseeSeetha ShankaranDivision of Neonatology and Perinatal Medicine, Wayne State University, Detroit, MichiganNeil N. FinerUniversity of California at San Diego Medical Center, University of California, San Diego, CaliforniaJames A. LemonsDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana

2004en

ABI

Аннотация

BACKGROUND: Glutamine is one of the most abundant amino acids in both plasma and human milk, yet it is not included in standard intravenous amino acid solutions. Previous studies have suggested that parenteral nutrition (PN) supplemented with glutamine may reduce sepsis and mortality in critically ill adults. Whether glutamine supplementation would provide a similar benefit to extremely low birth weight (ELBW) infants is not known. METHODS: We performed a multicenter, randomized, double-masked, clinical trial to assess the safety and efficacy of early PN supplemented with glutamine in decreasing the risk of death or late-onset sepsis in ELBW infants. Infants 401 to 1000 g were randomized within 72 hours of birth to receive either TrophAmine (control) or an isonitrogenous study amino acid solution with 20% glutamine whenever they received PN up to 120 days of age, death, or discharge from the hospital. The primary outcome was death or late-onset sepsis. RESULTS: Of the 721 infants who were assigned to glutamine supplementation, 370 (51%) died or developed late-onset sepsis, as compared with 343 of the 712 infants (48%) assigned to control (relative risk: 1.07; 95% confidence interval: 0.97-1.17). Glutamine had no effect on tolerance of enteral feeds, necrotizing enterocolitis, or growth. No significant adverse events were observed with glutamine supplementation. CONCLUSIONS: Parenteral glutamine supplementation as studied did not decrease mortality or the incidence of late-onset sepsis in ELBW infants. Consequently, although no harm was demonstrated, routine use of parenteral glutamine supplementation cannot be recommended in this population.

Перевод пока недоступен

Идентификаторы

DOI: 10.1542/peds.113.5.1209

Цитирования и источники

Цитирований: 2Использованных источников: 0

Показатели — AkademScholar