L-alanyl-L-glutamine-supplemented parenteral nutrition decreases infectious morbidity rate in patients with severe acute pancreatitis
Por:
Fuentes-Orozco C., Cervantes-Guevara G., Muciño-Hernández I., López-Ortega A., Ambriz-González G., Gutiérrez-De-La-Rosa J.L., Gómez-Herrera E., Hermosillo-Sandoval J.M., González-Ojeda A.
Publicada:
1 ene 2008
Resumen:
Background: The effect of parenteral GLN on recovery from severe acute pancreatitis has not been thoroughly investigated. The aims of this study were to determine whether parenteral GLN improves nutrition status and immune function, and to determine its ability to reduce morbidity and mortality in patients with this condition. Methods: In a randomized clinical trial, 44 patients with severe acute pancreatitis were randomly assigned to receive either standard PN (n = 22) or L-alanyl-L-glutamine-supplemented PN (n = 22) after hospital admission. Nitrogen balance, counts of leukocytes, total lymphocytes, and CD4 and CD8 subpopulations, and serum levels of immunoglobulin A, total protein, albumin, C-reactive protein, and serum interleukin (IL)-6 and IL-10 were measured on days 0, 5, and 10. Hospital stay, infectious morbidity, and mortality were also evaluated. Results: Demographics, laboratory characteristics, and pancreatitis etiology and severity at entry to the study were similar between groups. The study group exhibited significant increases in serum IL-10 levels, total lymphocyte and lymphocyte subpopulation counts, and albumin serum levels. Nitrogen balance also improved to positive levels in the study group and remained negative in the control group. Infectious morbidity was more frequent in the control group than in the study group. The duration of hospital stay was similar between groups, as was mortality. Conclusion: The results suggest that treatment of patients with GLN-supplemented PN may decrease infectious morbidity rate compared with those who treated with nonenriched PN. © 2008 American Society for Parenteral and Enteral Nutrition.
Filiaciones:
Fuentes-Orozco C.:
Medical Research Unit in Clinical Epidemiology, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
Cervantes-Guevara G.:
Department of Nutritional Support, Civil Hospital Fray Antonio Alcalde, University of Guadalajara, Guadalajara, Jalisco, Mexico
Muciño-Hernández I.:
Medical Research Unit in Clinical Epidemiology, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
López-Ortega A.:
Medical Research Unit in Clinical Epidemiology, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
Ambriz-González G.:
Medical Research Unit in Clinical Epidemiology, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
Gutiérrez-De-La-Rosa J.L.:
Department of General Surgery and Nutritional Support, Specialties Hospital at Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
Gómez-Herrera E.:
Department of General Surgery and Nutritional Support, Specialties Hospital at Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
Hermosillo-Sandoval J.M.:
Department of General Surgery and Nutritional Support, Specialties Hospital at Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
González-Ojeda A.:
Medical Research Unit in Clinical Epidemiology, Western Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico
C. Jose Enrique Rodo # 2558, Colonia Prados Providencia, 44657, Guadalajara, Jalisco, Mexico
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