Table 6.

Glutamine in pediatric patients with severe burns/trauma.

Reference	Subjects	Design	Gln	Control	Outcomes	Results
Sheridan et al. 2004 [190]	7 pediatric patients aged 1.3–15.8 y with serious burns (≥20% of BSA) tolerating enteral feedings	Randomized double-blind crossover	Enteral Gln; EN (Pediasure and/or Jevity) with Gln (0.6 g/kg/d) replacing 20% of essential and nonessential AA for 48–72 h (n = 7)	Isocaloric isonitrogenous standard EN (Pediasure and/or Jevity) supplemented with modular protein (Promod) for 48–72 h (n = 7)	Whole-body protein kinetics (IV infusion of L-[1–13C]Leu, NaH13CO3) after 48 h enteral feeding (fed state), nitrogen balance, plasma Gln concentrations	Decreased Leu flux and Leu oxidation rate, no differences in net balance of Leu accretion into proteins, nitrogen balance or plasma Gln concentrations, well tolerated
Chuntrasakul et al. 2003 [195]	36 trauma patients aged 15–60 y (n = 16 severe trauma; n = 20 burn BSA 30–60%)	Randomized controlled	Enteral Gln; exclusive EN enriched with Arg, Gln, omega-3 fatty acids (Neomune) started on postinjury d-2 until d-10 (≤0.15 g/kg/d Gln) (n = 18)	Standard exclusive EN for trauma patients (traumacal) started on postinjury d-2 until d-10 (≤0.07 g/kg/d Gln) (n = 18)	Biochemical and immune parameters after 10 d supplementation, morbidity, and mortality	No differences in immunologic or biochemical parameters (except increased serum total protein, decreased serum triglycerides), no significant differences in nitrogen balance, LOS in ICU/hospital, d to wean off ventilator, or mortality, well tolerated
Yang and Xu, 2007 [196]	46 patients aged 7–68 y with severe traumatic brain injury	Randomized controlled	Enteral or parenteral Gln; Gln-Ala dipeptide (n = 23)	Routine nutritional therapy (n = 23)	LOS in neurosurgical ICU, mortality, lymphocyte count, and related complications	No significant differences in mortality, LOS in neurosurgical ICU, lung infection or alimentary tract hemorrhage or lymphocyte count

BSA: body surface area; EN: enteral nutrition; AA: amino acid; IV: intravenous; LOS: length of stay; ICU: intensive care unit.