Intravenous glutamine for severe acute pancreatitis: A meta-analysis

Abstract

Aim: To evaluate the efficacy of intravenous glutamine on the patients with severe acute pancreatitis (SAP).

Methods: The Cochrane Library, PubMed, EMBASE, and EBM review databases were searched up to June 2012. Randomized controlled trials (RCTs) that compared non-glutamine nutrition with intravenous glutamine supplemented nutrition in patients with SAP were included. A method recommended by the Cochrane Collaboration was used to perform a meta-analysis of those RCTs.

Results: Four RCTs involving a total of 190 participants were included. Analysis of these RCTs revealed the presence of statistical homogeneity among them. Results showed that glutamine dipeptide has a positive effect in reducing the mortality rate (OR = 0.26, 95%CI: 0.09-0.73, P = 0.01), length of hospital stay (weighted mean difference = -4.85, 95%CI: 6.67--3.03, P < 0.001), and the rate of complications (OR = 0.41, 95%CI: 0.22-0.78, P = 0.006). No serious adverse effects were found.

Conclusion: Current best evidence demonstrates that glutamine is effective for SAP. Further high quality trials are required and parameters of nutritional condition and hospital cost should be considered in future RCTs with sufficient size and rigorous design.

Keywords: Glutamine; Meta-analysis; Severe acute pancreatitis.

Figure 1

Flow diagram of the study selection process.

Figure 2

Effect of glutamine dipeptide. A: On mortality for severe acute pancreatitis (SAP); B: On length of hospital stay for SAP; C: On rate of complications for SAP.