Effect of a glutamine-enriched enteral diet on intestinal permeability and infectious morbidity at 28 days in critically ill patients with systemic inflammatory response syndrome:: A randomized, single-blind, prospective, multicenter study

OBJECTIVES: We investigated the effect of a glutamine-enriched enteral diet on intestinal permeability and infectious morbidity and mortality in critically ill patients who developed systemic inflammatory response syndrome after an acute event. METHODS: Eleven intensive care units in tertiary-care hospitals participated in a prospective, randomized, single blind, multicenter trial. Eighty-four patients with systemic inflammatory response syndrome of any etiology were randomly allocated to receive a glutamine-enriched enteral diet or a control diet without glutamine. RESULTS: Most patients received the planned caloric intake. The number of infected patients was smaller in the glutamine group than in the control group (11 versus 17 patients, P < 0.05), with a relative risk of 0.5 (95% confidence interval = 0.3-0.9). The most frequent infection was nosocomial pneumonia, with 11 (33%) patients in the control group and 6 (14%) in the glutamine group. There were no differences with respect to, other infections., mortality, or length of stay. Intestinal permeability as assessed by the lactulose-mannitol test was unchanged in both groups. CONCLUSION: Glutamine-enriched enteral diets can decrease nosocomial infections in patients with systemic inflammatory response syndrome. (C) Elsevier Science Inc. 2002.