The Effect of Intravenous Glutamine on the SOFA Score of Severely Burn Patients Receiving Enteral Nutrition in the Intensive Care Unit, a Randomized Controlled Trial

Background: Glutamine is an amino acid that has been shown to be beneficial for the metabolically stressed patient, especially the critically ill patients as it is important in modulation of immune cell function and production of cytokines. In this randomized controlled trial, we tested the effects of glutamine supplementation intravenously in severely burn patients with enteral nutrition in ICU on infectious complications. Patients and Methods: Eighty two patients with burn more than forty percent of BSA in the ICU were randomized into two groups; Group G (glutamine group) and Group C (control group). Patients received continuous intravenous infusion of alanyl-glutamine (0.5g/kg/day) via central venous access until discharge from the ICU, death, or for maximum of 2 weeks and saline (2.5ml/kg/day) in Group C. SOFA score was calculated on admission and on the last day for each patient in the ICU, to determine whether IV glutamine affected the rate of infection, the length of stay in ICU and the in hospital mortality. Results: Both groups had similar range of SOFA score {6-14}, the mean was (0.07±1.96) in Group G and (0.12±1.54) in Group C, p=(0.91). The ICU stay in Group G was (7.0±2.4) and (7.2±1.0) in Group C, p=(0.551). The in hospital mortality was (1.7±1.1) in Group G and (1.8±1.2) in Group C, p= (0.630). Conclusion: In burn patients more than 40% in ICU on enteral nutrition, intravenous glutamine showed no significant reduction in the SOFA scoring, length of ICU stay and in hospital stay and mortality than the control group.