The impact of oral glutamine supplementation on the intestinal permeability and incidence of necrotizing enterocolitis/septicemia in premature neonates.

Abstract

OBJECTIVE:

To examine the impact of oral glutamine (Gln) supplementation on gut integrity and on the incidence of necrotizing enterocolitis (NEC)/septicemia of premature neonates.

METHODS:

Preterm neonates (n = 101, gestational age <34 weeks, birth weight <2000 g) were randomly allocated to receive from day 3 to day 30 postpartum, either oral Gln (0.3 g/kg/day, n = 51-Gln group) or placebo (caloreen-isocaloric, n = 50-control group). Intestinal permeability was determined from the urinary lactulose/mannitol recovery (L/M ratio) following their oral administration and assessed at three time points: day 2 (before first administration), day 7 and day 30 of life. The incidence of NEC and septicemia over the study period was also recorded.

RESULTS:

A decrease of lactulose recovery at days 7 (p = 0.001) and 30 (p < 0.001) and a decrease of L/M ratio at day 7 (p = 0.002) were observed only in the Gln group. Lactulose recovery and L/M ratio at day 7 (p = 0.022 and p = 0.004, respectively), as well as lactulose recovery (p = 0.001), mannitol recovery (p = 0.042), and L/M ratio (p = 0.001) at day 30, were decreased in the Gln group as compared to controls. NEC and septicemia were lower in the Gln group at the end of the first week (p = 0.009 and p = 0.041, respectively) and up to the end of the study (p < 0.001 and p = 0.048, respectively).

CONCLUSION:

Oral Gln administration may have beneficial effects on intestinal integrity and the overall incidence of NEC/septicemia in preterm infants.

• Authors: Sofia Sevastiadou, Ariadne Malamitsi-Puchner, Christos Costalos, Maria Skouroliakou, Despina D Briana, Aris Antsaklis, Eleftheria Roma-Giannikou
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 24 Issue 10 Pg. 1294-300 (Oct 2011) ISSN: 1476-4954 [Electronic] England
• PMID: 21463215 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Glutamine

Topics

• Administration, Oral
• Dietary Supplements
• Double-Blind Method
• Enterocolitis, Necrotizing (prevention & control)
• Female
• Glutamine (pharmacology, therapeutic use)
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (prevention & control)
• Intestinal Absorption (drug effects)
• Intestinal Mucosa (drug effects, metabolism)
• Male
• Permeability (drug effects)
• Sepsis (prevention & control)