Evidence map›Paper›PMID 26283217›Full record

SynthesisCritical care (London, England)2015

Enteral glutamine supplementation in critically ill patients: a systematic review and meta-analysis.

Arthur R H van Zanten, Rupinder Dhaliwal, Dominique Garrel, Daren K Heyland

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 5 pooled it
11.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 5 syntheses or guidelines pooled it, 125 citations in OpenAlex.

  1. Enteral glutamine supplements for patients with severe burns: A systematic review and meta-analysis.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024
    Pooled it
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  3. Immunonutrition for acute respiratory distress syndrome (ARDS) in adults.The Cochrane database of systematic reviews · 2019
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  20. An Overview of Recent Developments in the Management of Burn Injuries.International journal of molecular sciences · 2023
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Arthur R H van ZantenDepartment of Intensive Care Medicine, Gelderse Vallei Hospital, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands. zantena@zgv.nl.
Rupinder DhaliwalClinical Evaluation Research Unit, Kingston General Hospital, Angada 4, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. dhaliwar@kgh.kari.net.
Dominique GarrelDepartment of Nutrition, University of Montreal, Pavillon Liliane de Stewart, 2405, Chemin de la Côte-Sainte-Catherine, Local 1204, Montreal, QC, H3T 1A8, Canada. dominique.garrel@umontreal.ca.
Daren K HeylandClinical Evaluation Research Unit, Kingston General Hospital, Angada 4, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. dkh2@queensu.ca.
Kingston General Hospital · CAHEC Montréal · CAZiekenhuis Gelderse Vallei · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionGlutamine (GLN) has been suggested to have a beneficial influence on outcomes of critically ill patients. However, recent large-scale trials have suggested harm associated with GLN supplementation. Recently, systematic reviews on the use of parenteral GLN have been published; however, less information is available on the role of enteral GLN. Therefore, the aim of this systematic review was to study the effects of enteral GLN supplementation in patients with critical illness.

methodsWe identified randomized controlled trials conducted from 1980 to 2014 with enterally administered GLN in adult critically ill patients. Studies of parenteral GLN only or combined enteral-parenteral GLN were excluded. The methodological quality of studies was scored, and trial data were statistically combined. We examined a priori the treatment effects in subgroups of trials of burn and trauma patients.

resultsA total of 11 studies involving 1079 adult critically ill patients and enteral GLN supplementation were identified. Enteral GLN supplementation was not associated with a reduction of hospital mortality (risk ratio [RR] 0.94, 95% confidence interval [CI] 0.65-1.36; p = 0.74), infectious complications (RR 0.93, 95% CI 0.79-1.10; p = 0.39) or stay in the intensive care unit (weighted mean difference [WMD] -1.36 days, 95% CI -5.51 to 2.78; p = 0.52). However, there was a significant reduction in hospital stay (WMD 4.73 days, 95% CI -8.53 to -0.90; p = 0.02). In the subset of studies of patients with burns, enteral GLN supplementation was associated with significant reductions in hospital mortality (RR 0.19, 95% 0.06-0.67; p = 0.010) and hospital stay (WMD -9.16, 95% CI -15.06 to -3.26; p = 0.002). There was no effect in trauma patients.

conclusionsEnteral GLN supplementation does not confer significant clinical benefit in critically ill patients, with the exception of reduced hospital stay. There may be a significant benefit in patients with burns, but data are sparse and larger randomized trials are warranted to confirm this effect.

Indexed as

AdultCritical IllnessDietary SupplementsEnteral NutritionGlutamineHumansLength of StayGlutamine

Identifiers

PMID26283217
PMCPMC4539709
OpenAlexW1822346164

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.