The following is a summary of “Efficacy of Glutamine Supplementation in Severe Adult Burn Patients: A Systematic Review With Trial Sequential Meta-Analysis,” published in the July 2023 issue of Critical Care by Ortiz-Reyes et al.
Uncertainty in glutamine supplementation efficacy for severe burn patients due to variable randomized controlled trials (RCTs) results. Researchers conducted a systematic review to analyze the impact of glutamine supplementation on mortality in severe adult burn patients.
They searched MEDLINE, Embase, CINAHL, and Cochrane Central from inception to February 10, 2023. Evaluated were RCTs investigating the sole impact of enteral or IV glutamine on severe adult burn patients. Two reviewers extracted data on study and burn characteristics, intervention details, adverse events, and outcomes.
The results showed random effects meta-analyses yielded pooled risk ratios (RRs). Trial sequential analysis (TSA) was conducted for mortality and infectious complications. Ten RCTs (1,577) were included. Significant effect of glutamine supplementation on overall mortality not noted (RR, 0.65, 95% CI, 0.33–1.28; P=0.21), infectious complications (RR, 0.83; 95% CI, 0.63–1.09; P=0.18), or secondary outcomes were observed. Subgroup analyses revealed no significant effects based on administration route or burn severity. A considerable subgroup effect between single and multicenter RCTs was noted: glutamine reduced mortality and infectious complications in single-center RCTs but not multicenter RCTs. TSA indicated that pooled results of single-center RCTs were type 1 errors, rendering further trials futile.
They concluded glutamine supplementation doesn’t improve burn patient outcomes.