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Effect on immune indices of preoperative intravenous glutamine dipeptide supplementation in malnourished abdominal surgery patients in the preoperative and postoperative periods.
Nutrition. 2009 Sep; 25(9):920-5.N

Abstract

OBJECTIVE

To determine if parenteral glutamine dipeptide supplementation given only in the preoperative period in malnourished patients after gastrointestinal surgery would sustain its effects into the first postoperative week, as shown by immune indices.

METHODS

A prospective randomized study on malnourished adult patients for abdominal surgery was done where one group (n = 17) received preoperative glutamine supplementation (0.3 g . kg(-1) x d(-1)) for 5 d and the other (n = 17) had none. Both received isocaloric (30 kcal x kg(-1) x d(-1)) and isonitrogenous (1.5 g x kg(-1) x d(-1)) nutrition. Outcomes were 1) immune indices on admission (day 1), the day before surgery (day 2), and the seventh postoperative day (day 3); and 2) clinical outcomes were infection, wound complication, days in the intensive care unit, and mortality. Statistical tests were repeated samples analysis of variance, Friedman's test, Wilcoxon's test, and t test for individual comparison.

RESULTS

The glutamine-supplemented group showed an increase in total white blood cells (from 8700 on day to 11 080 on day 2, P = 0.026), granulocytes (from 6177 on day 1 to 8568 on day 2, P = 0.039), and lymphocytes (from 1516 on day 1 to 1747 on day 2, P = 0.049). Significant decreases in glutamine-supplemented group values from day 2 to day 3 occurred in granulocytes, lymphocytes, and CD8, CD22, and CD19 cells. Clinical outcome was similar in both groups. Intake was adequate in both groups (preoperative 85% versus postoperative 82% computed) and the mean glutamine delivered was 18 g/d.

CONCLUSION

Parenteral glutamine supplementation in the preoperative period resulted in increased white blood cell, granulocyte, and lymphocyte counts, which was not sustained in the first week of the postoperative period, when supplementation was discontinued before surgery.

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Authors+Show Affiliations

Asprer JM
St Lukes Medical Center, Clinical Nutrition, Obesity, and Weight Management Center, Philippines.
Llido LO
No affiliation info available
Sinamban R
No affiliation info available
Schlotzer E
No affiliation info available
Kulkarni H
No affiliation info available

MeSH

AbdomenAdultAntigens, CDCritical CareDietary SupplementsDigestive System Surgical ProceduresDipeptidesFemaleGlutamineGranulocytesHumansInfusions, IntravenousLeukocyte CountLymphocytesMaleMalnutritionMiddle AgedPerioperative CarePostoperative CarePostoperative PeriodProspective Studies

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19647623

Citation

Asprer, Jonathan M., et al. "Effect On Immune Indices of Preoperative Intravenous Glutamine Dipeptide Supplementation in Malnourished Abdominal Surgery Patients in the Preoperative and Postoperative Periods." Nutrition (Burbank, Los Angeles County, Calif.), vol. 25, no. 9, 2009, pp. 920-5.
Asprer JM, Llido LO, Sinamban R, et al. Effect on immune indices of preoperative intravenous glutamine dipeptide supplementation in malnourished abdominal surgery patients in the preoperative and postoperative periods. Nutrition. 2009;25(9):920-5.
Asprer, J. M., Llido, L. O., Sinamban, R., Schlotzer, E., & Kulkarni, H. (2009). Effect on immune indices of preoperative intravenous glutamine dipeptide supplementation in malnourished abdominal surgery patients in the preoperative and postoperative periods. Nutrition (Burbank, Los Angeles County, Calif.), 25(9), 920-5. https://doi.org/10.1016/j.nut.2009.01.014
Asprer JM, et al. Effect On Immune Indices of Preoperative Intravenous Glutamine Dipeptide Supplementation in Malnourished Abdominal Surgery Patients in the Preoperative and Postoperative Periods. Nutrition. 2009;25(9):920-5. PubMed PMID: 19647623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect on immune indices of preoperative intravenous glutamine dipeptide supplementation in malnourished abdominal surgery patients in the preoperative and postoperative periods. AU - Asprer,Jonathan M, AU - Llido,Luisito O, AU - Sinamban,Reynaldo, AU - Schlotzer,Ewald, AU - Kulkarni,Hrishikesh, PY - 2008/03/07/received PY - 2008/07/08/revised PY - 2009/01/06/accepted PY - 2009/8/4/entrez PY - 2009/8/4/pubmed PY - 2009/10/24/medline SP - 920 EP - 5 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 25 IS - 9 N2 - OBJECTIVE: To determine if parenteral glutamine dipeptide supplementation given only in the preoperative period in malnourished patients after gastrointestinal surgery would sustain its effects into the first postoperative week, as shown by immune indices. METHODS: A prospective randomized study on malnourished adult patients for abdominal surgery was done where one group (n = 17) received preoperative glutamine supplementation (0.3 g . kg(-1) x d(-1)) for 5 d and the other (n = 17) had none. Both received isocaloric (30 kcal x kg(-1) x d(-1)) and isonitrogenous (1.5 g x kg(-1) x d(-1)) nutrition. Outcomes were 1) immune indices on admission (day 1), the day before surgery (day 2), and the seventh postoperative day (day 3); and 2) clinical outcomes were infection, wound complication, days in the intensive care unit, and mortality. Statistical tests were repeated samples analysis of variance, Friedman's test, Wilcoxon's test, and t test for individual comparison. RESULTS: The glutamine-supplemented group showed an increase in total white blood cells (from 8700 on day to 11 080 on day 2, P = 0.026), granulocytes (from 6177 on day 1 to 8568 on day 2, P = 0.039), and lymphocytes (from 1516 on day 1 to 1747 on day 2, P = 0.049). Significant decreases in glutamine-supplemented group values from day 2 to day 3 occurred in granulocytes, lymphocytes, and CD8, CD22, and CD19 cells. Clinical outcome was similar in both groups. Intake was adequate in both groups (preoperative 85% versus postoperative 82% computed) and the mean glutamine delivered was 18 g/d. CONCLUSION: Parenteral glutamine supplementation in the preoperative period resulted in increased white blood cell, granulocyte, and lymphocyte counts, which was not sustained in the first week of the postoperative period, when supplementation was discontinued before surgery. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/19647623/Effect_on_immune_indices_of_preoperative_intravenous_glutamine_dipeptide_supplementation_in_malnourished_abdominal_surgery_patients_in_the_preoperative_and_postoperative_periods_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(09)00119-1 DB - PRIME DP - Unbound Medicine ER -