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CRITICAL CARE AND TRAUMA

The Effect of Intravenous Alanyl-Glutamine Supplementation on Plasma Glutathione Levels in Intensive Care Unit Trauma Patients Receiving Enteral Nutrition: The Results of a Randomized Controlled Trial

From the Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Address correspondence and reprint requests to Ahmet Eroglu, MD, Karadeniz Technical University, Tip Fakultesi, Anesteziyoloji, 61080 Trabzon, Turkey. Address e-mail to aheroglu{at}hotmail.com.

Background: We sought to investigate the effect of IV alanyl-glutamine supplementation on plasma glutathione levels in severely traumatized patients receiving enteral nutrition.

METHODS: Forty adult patients with severe trauma according to the Injury Severity Score >20 were enrolled in this randomized, controlled study. The patients were assigned to two groups: Group G received 0.5 g · kg^–1 · d^–1 of alanyl-glutamine dipeptide supplementation IV, and Group C received a control solution without alanyl-glutamine for 7 days. Blood samples were taken for analysis of glutathione before the initiation of supplementation and on the 3rd, 7th, and 10th days of feeding.

RESULTS: Total plasma glutathione levels significantly increased in Group G when compared with Group C on Days 7 and 10 (1.34 ± 0.20 µM vs 1.13 ± 0.14 µM, and 1.38 ± 0.19 µM vs 1.12 ± 0.16 µM) (P < 0.001).

CONCLUSIONS: This study demonstrates that IV alanyl-glutamine supplementation for 7 days increases total plasma glutathione levels in critically ill trauma patients receiving standard enteral nutrition.