[Glutamine and immunonutrition for burn patients]

Abstract

Nutritional therapy is an important determinant of immune function in burn patients. However, common nutritional supplement given to patients with extensive deep burn is still therapeutically inefficient to block nutrients utilization due to metabolic disorder. Immunonutrition, a new nutrition therapeutic modality, has been used in severely burned patients for regulating cell function, improving metabolic state, and enhancing immune function. Glutamine (Gln) is often considered to be a prime immunonutrient in immunonutrition therapy for critically ill patients including those with serious burns. Our series of experimental and clinical studies have demonstrated that Gln administered in animals or patients could abate intestinal injury, accelerate repair of intestinal mucosa, improve nitrogen balance, abate immunosuppression, maintain immune homeostasis, ameliorate wound healing, and shorten hospital stay. Although the use of Gln for supportive care of severely burned patients is now well established, the science of its use is still in its infancy. There are some disputes in regard to its indication, dosage, and course of treatment, and the way of its supplementation, administration opportunity especially. These questions will be discussed in this paper, and we wish to propose the principle and method of administration of Gln in severely burned patients.