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

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 mu M vs 1.13 +/- 0.14 mu M, and 1.38 +/- 0.19 mu M vs 1.12 +/- 0.16 mu M) (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. (Anesth Analg 2009;109:502-5)