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Review
. 2022 Oct 9:35:6-17.
doi: 10.1016/j.jpra.2022.09.003. eCollection 2023 Mar.

The Effects of Glutamine Supplementation on Reducing Mortality and Morbidity among Burn Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Hatan Mortada  1 , Nawaf Alhindi  2 , Abdulrahman Abukhudair  2 , Shahad Alanazi  3 , Alaa AlSahli  4 , Khalid Arab  5
Affiliations
Review

The Effects of Glutamine Supplementation on Reducing Mortality and Morbidity among Burn Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Hatan Mortada et al. JPRAS Open. .

Abstract

Glutamine (GLN) has been proven to improve the prognosis of severely burned patients. GLN supplementation in critical illness has gained extreme popularity among researchers over the years, and its safety and efficacy are still under question. Therefore, we aim to study the role of GLN supplements in decreasing mortality, length of hospitalization (LOH), and infection in severely burned patients. PRISMA guidelines were used to design and conduct this systematic review. MEDLINE, Cochrane, and EMBASE databases were used to search for randomized controlled trials (RCTs) in January 2022. In order to assist in the search, MeSH terms such as burn injury, GLN, and RCT were used. As a result of reviewing the literature, 1112 publications were found. We included only 7 RCTs after implanting our inclusion criteria. There were 328 patients enrolled in the study, with 166 patients (50.61%) were allocated to GLN supplementation and 162 patients in the control groups (49.39%). The risk of infection was significantly lower among patients who received GLN supplementation than those in the control groups (RR = 0.41, 95% CI, 0.18 to 0.92, p = 0.030). The risk of death was significantly lower among GLN-receiving patients compared to non-GLN-receiving patients (RR = 0.09, 95% CI, 0.01 to 0.63, p = 0.016). GLN supplementation has been linked to lower hospital mortality and infection-related morbidity in burn patients. Furthermore, larger-scale and higher-quality studies are needed to assess whether there are any statistically and clinically significant changes.

Keywords: Glutamine (GLN); burn; critically ill patients; meta-analysis; nutrition.

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Conflict of interest statement

The author(s) declare no potential competing of interest with respect to the research, authorship, and/or publication of this article

Figures

Figure 1
Figure 1
PRISMA flow chart for the systematic review.
Figure 2
Figure 2
Forest plots depict the difference in the risk of suspected infection (A), confirmed infection (B) and mortality (C) between burn patients who received GLN and those who did not receive GLN.
Figure 3
Figure 3
A forest plot shows the MD in the length of hospital stay (A) and the results of the influence analysis (sensitivity) for the same outcome (B).
Figure 4
Figure 4
Funnel plots show the risk of publication bias across different outcomes in the meta-analysis, including the suspected infection (A), confirmed infection (B), mortality (C), and the LOH (D).
Figure 5
Figure 5
Risk of bias assessment summary
See this image and copyright information in PMC

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