%0 Journal Article
%T Gut mucosal and plasma concentrations of glutamine: a comparison between two enriched enteral feeding solutions in critically ill patients
%A Jean-Charles Preiser
%A Daliana Peres-Bota
%A Pierre Eisendrath
%A Jean-Louis Vincent
%A Andr¨¦ Van Gossum
%J Nutrition Journal
%D 2003
%I BioMed Central
%R 10.1186/1475-2891-2-13
%X Following randomization, glutamine concentration was determined in endoscopically sampled duodenal biopsies and plasma, before and after a 7-day period of continuous administration of the designated solution.The mucosal concentration of glutamine increased in the duodenal biopsies sampled from patients randomized to the solution containing the glutamine-rich proteins (from 3.6 ¡À 2.2 to 6.7 ¡À 5.2 micro-mol/g protein), but not from the others. There were no differences between the 3 groups in the plasma concentrations of glutamine, which remained stable over time.The source of supplemental glutamine can influence gut mucosal glutamine concentrations, suggesting differences in its availability or utilization.Addition of glutamine to the nutritional support provided to critically ill patients has been suggested, namely to prevent gut dysfunction and subsequent multiple organ failure. The beneficial effects of glutamine supplementation to critically ill patients have been shown in at least two controlled studies [1,2], where patients randomized to a glutamine-enriched regimen had improved long-term survival [1] and reduced septic morbidity [2]. Although incompletely elucidated, the beneficial effects of these enriched solutions may have been related to the intestinal effects of glutamine. Reported intestinal effects of glutamine include the maintenance of gut barrier function, intestinal cell proliferation and differentiation, increased DNA and protein content and synthesis, and decreased production of pro-inflammatory cytokines [3-9]. The intestinal extraction rate of glutamine is higher than other amino acids [10,11].The enteral route is preferred for nutritional support in critically ill patients [12]. In addition, the gut barrier function is better preserved when glutamine is supplied on the apical rather than the basolateral side of the enterocyte [13]. Therefore, the enrichment of the glutamine content of enteral feeding solutions is a logical and attractive therap
%U http://www.nutritionj.com/content/2/1/13