Cost containment through L-alanyl-L-glutamine supplemented total parenteral nutrition after major abdominal surgery: a prospective randomized double-blind controlled study
N. Mertes et al., Cost containment through L-alanyl-L-glutamine supplemented total parenteral nutrition after major abdominal surgery: a prospective randomized double-blind controlled study, CLIN NUTR, 19(6), 2000, pp. 395-401
Background & Aims: Glutamine is recognized as a conditionally essential ami
no acid. Recent studies indicate that glutamine-containing total parenteral
nutrition improves nitrogen economy, enhances gastrointestinal and immune
functions and shortens hospital stay.
Methods: Thirty-seven patients (19 w and 18 m; age 61.4 +/- 10.4 years; BMI
23.7 +/- 2.8 kg/m(2)) following major abdominal surgery receiving an isoni
trogenous isoenergetic TPN with or without alanyl-glutamine supplementation
(0.5 g/kg BW/day), were evaluated in a double-blind, randomized, controlle
d trial over a five-day period by measuring nitrogen balance, selected bioc
hemical parameters and length of hospital stay.
Results: Supplemental alanyl-glutamine improved the overall mean (-3.5 +/-
1.6 vs. -5.5 +/- 1.4 g N; P < 0.05) and cumulative nitrogen balance (-14.1
+/- 9.1 vs. -21.7 +/- 11.4 g N; P < 0.05) compared with the isonitrogenous,
isoenergetic standard regimen. Alanyl-glutamine normalized plasma glutamin
e concentration and reduced the length of hospital stay (12.8 +/- 2.6 vs. 1
7.5 +/- 6.4 days; P < 0.05).
Conclusions: The results of the study confirm that supplementation with syn
thetic alanyl-glutamine dipeptide is associated with cost containment due t
o shortened hospitalization and improved nitrogen economy. (C) 2000 Harcour
t Publishers Ltd.