A Randomized Trial of Enteral Glutamine for Treatment of Burn Injuries - PubMed (original) (raw)

Randomized Controlled Trial

. 2022 Sep 15;387(11):1001-1010.

doi: 10.1056/NEJMoa2203364. Epub 2022 Sep 9.

Lucy Wibbenmeyer 1, Jonathan Pollack 1, Bruce Friedman 1, Alexis F Turgeon 1, Niknam Eshraghi 1, Marc G Jeschke 1, Sylvain Bélisle 1, Daisy Grau 1, Samuel Mandell 1, Sai R Velamuri 1, Gabriel Hundeshagen 1, Naiem Moiemen 1, Kayvan Shokrollahi 1, Kevin Foster 1, Fredrik Huss 1, Declan Collins 1, Alisa Savetamal 1, Jennifer M Gurney 1, Nadia Depetris 1, Christian Stoppe 1, Luis Ortiz-Reyes 1, Dominique Garrel 1, Andrew G Day 1; RE-ENERGIZE Trial Team

Collaborators, Affiliations

Free article

Randomized Controlled Trial

A Randomized Trial of Enteral Glutamine for Treatment of Burn Injuries

Daren K Heyland et al. N Engl J Med. 2022.

Free article

Abstract

Background: Glutamine is thought to have beneficial effects on the metabolic and stress response to severe injury. Clinical trials involving patients with burns and other critically ill patients have shown conflicting results regarding the benefits and risks of glutamine supplementation.

Methods: In a double-blind, randomized, placebo-controlled trial, we assigned patients with deep second- or third-degree burns (affecting ≥10% to ≥20% of total body-surface area, depending on age) within 72 hours after hospital admission to receive 0.5 g per kilogram of body weight per day of enterally delivered glutamine or placebo. Trial agents were given every 4 hours through a feeding tube or three or four times a day by mouth until 7 days after the last skin grafting procedure, discharge from the acute care unit, or 3 months after admission, whichever came first. The primary outcome was the time to discharge alive from the hospital, with data censored at 90 days. We calculated subdistribution hazard ratios for discharge alive, which took into account death as a competing risk.

Results: A total of 1209 patients with severe burns (mean burn size, 33% of total body-surface area) underwent randomization, and 1200 were included in the analysis (596 patients in the glutamine group and 604 in the placebo group). The median time to discharge alive from the hospital was 40 days (interquartile range, 24 to 87) in the glutamine group and 38 days (interquartile range, 22 to 75) in the placebo group (subdistribution hazard ratio for discharge alive, 0.91; 95% confidence interval [CI], 0.80 to 1.04; P = 0.17). Mortality at 6 months was 17.2% in the glutamine group and 16.2% in the placebo group (hazard ratio for death, 1.06; 95% CI, 0.80 to 1.41). No substantial between-group differences in serious adverse events were observed.

Conclusions: In patients with severe burns, supplemental glutamine did not reduce the time to discharge alive from the hospital. (Funded by the U.S. Department of Defense and the Canadian Institutes of Health Research; RE-ENERGIZE ClinicalTrials.gov number, NCT00985205.).

Copyright © 2022 Massachusetts Medical Society.

PubMed Disclaimer

Publication types

MeSH terms

Substances

LinkOut - more resources