Nutritional controversies in critical care: revisiting enteral glutamine during critical illness and injury.

This article examines some of the articles that inspired recent changes to critical care guidelines related to glutamine in enteral nutrition. Two recent multicenter randomized controlled trials involving enteral glutamine have reported increased mortality rates in groups of mechanically ventilated adult patients, while demonstrating no additional benefits to other outcomes, such as nosocomial infections. Recent studies suggest that enteral glutamine supplementation may not provide significant clinical benefits to adult patients on mechanical ventilation with multiple organ failure, but more information is still needed when attempting to apply these results to other groups of critical care patients.