Efectividad de la utilización perioperatoria de glutamina en nutrición parenteral en pacientes con riesgo de desnutrición moderada-severa
2011
Background & aims: To determine whether perioperative
glutamine supplementation of parenteral nutrition
(PN) has an impact on morbidity and mortality of
patients with previous moderate to severe risk of malnutrition.
Methods: A quasi-experimental study was conducted
comparing the following groups: Control group 1: without
glutamine dipeptide supplementation of PN during
the perioperative period. Control group 2: PN was supplemented
with glutamine dipeptide (0.4 g/kg/day) after
surgery only. Group 3 (follow-up group): PN was supplemented
with glutamine dipeptide (0.4 g/kg/day) in the
perioperative period. Postoperative morbidity and mortality
was recorded.
Results: Sixty-seven patients matched for baseline and
surgical characteristics were recruited into the study.
Univariate analysis showed a lower incidence of hyperglycemia
and ICU admission in group 3, and a trend to
significance (P = 0.078) in terms of a lower incidence of
infection. In the multivariate analysis, only group 3 met
the models of ICU admission (OR = 0.28), hyperglycemia
(OR = 0.11), and renal failure (OR = 0.19).
Conclusions: The results show that perioperative use of
glutamine dipeptide in patients at risk of moderate to
severe malnutrition before surgery is an effective option
for decreasing the morbidity associated with malnutrition,
as it improves blood glucose modulation and reduces
infection and ICU stay.
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