Enteral glutamine supplementation in burn patients: a systematic review
and meta-analysis of randomized controlled trials
Abstract
Background: Glutamine is essential for various metabolic processes and
is a fundamental component in mechanisms involved in cellular resistance
against injury and mortality. However, the specific impact of enteral
glutamine administration on burn patients remains uncertain. We
performed this meta-analysis to establish glutamine’s role in managing
burn injury patients. Methods: We conducted a comprehensive search
across multiple electronic databases, including MEDLINE (via PubMed),
Embase, and various trial registries, to identify randomized controlled
trials that evaluated the effectiveness of enteral glutamine in burn
patients. To analyze the data, we employed a random-effects model and
presented dichotomous outcomes and continuous outcomes as relative risk
and mean difference, along with corresponding 95% confidence intervals,
respectively. Results: Our meta-analysis included 6 RCTs involving 1413
patients. Our primary outcome, all-cause mortality, was reported by 5
studies and was found to be comparable between the glutamine and control
groups (RR=0.66, 95% CI=0.22-1.94). There was no significant difference
between the glutamine and control group regarding the incidence of
infection (RR=0.93, 95% CI=0.67-1.30) and length of hospital stay (MD
-4.76 days, 95% CI=-10.63 to 1.11 days). Conclusion: The enteral
administration of glutamine does not decrease mortality in burn
patients. Further high-quality, large-scale randomized controlled trials
are needed to provide conclusive evidence.