Enteral Versus Parenteral Glutamine Supplement
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Purpose
Glutamine is a major fuel for the intestinal tract and immune cells and therefore affects the intestinal permeability (IP) and infection rate at critically ill patients. The preferential route of glutamine supplementation at critically ill patients still remains open. Therefore the researchers will investigate IP, infection rate and treatment outcome at patients supplemented with either parenteral or enteral glutamine.
A prospective randomized single blind study is performed at mechanically ventilated. Patients were randomly assigned to either parenteral (group P) or enteral (group E) glutamine supplemented group. Early enteral feeding is started in both groups. Patients are/will be treated with glutamine for five days. IP will be measured using lactulose/mannitol test (L/M) on the fourth day.
| Condition | Intervention | Phase |
|---|---|---|
|
Critically Ill |
Dietary Supplement: parenteral glutamine Dietary Supplement: enteral glutamine |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Comparison of Effect of Enteral Versus Parenteral Glutamine Supplement on Intestinal Permeability and Outcome of Critically Ill Patients |
- Intestinal Permeability - Lactulose-mannitol(L/M)Test [ Time Frame: 4 days after admission to intensive care unit ] [ Designated as safety issue: Yes ]
Measurement of intestinal permeability using lactulose-mannitol test (L/M test).
Intestinal permeability to sugars is an accurate test for detecting intestinal damage. Intestinal permeability of the epithelium to very small sugar molecules such as lactulose/mannitol may give useful information regarding the overall condition of the digestive tract.
Mannitol is absorbed transcellularly and lactulose has a paracellular route of absorption. Reduction in mannitol absorption shows reduced surface area and increased lactulose absorption indicates a leaky gut.
Lactulose and mannitol are given orally and later determined from the collected urine with HPTLC (high performance thin layer chromatography). The L/M ratio, as a result of lactulose-mannitol tests, is then calculated regarding urine lactulose and mannitol concentrations.
Thus, with the lactulose/mannitol test the intestinal permeability changes due to different reasons can be evaluated.
- Infection Rate at Participants in Both Groups [ Time Frame: participants were followed for the duration of ICU stay (average 3 weeks) ] [ Designated as safety issue: Yes ]Number of infections that occured at participants during study.
- 6-month Survival [ Time Frame: 6 month ] [ Designated as safety issue: No ]Six month follow up
| Enrollment: | 90 |
| Study Start Date: | October 2004 |
| Study Completion Date: | March 2009 |
| Primary Completion Date: | January 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: parentral glutamine
parenteral glutamine given in central venous line in dose up to 30 g par day
|
Dietary Supplement: parenteral glutamine
Dipeptiven, Fresenius Kabi, Graz, Austria was given intravenously through central venous line in a dose up to 30 g per day
Other Name: Dipeptiven, Fresenius Kabi, Graz, Austria
|
|
Experimental: entral glutamine
enteral glutamine given through gastric tube in a dose up to 30 g per day
|
Dietary Supplement: enteral glutamine
Alitraq, Abbott Laboratories, B.W. Zwolle, the Netherlands was given via nasogastric tube as continuous infusion of enteral diet, dose up to 30 g per day
Other Name: Alitraq, Abbott Laboratories, B.W. Zwolle, the Netherlands
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- mechanically ventilated critically-ill patients
- older than 18 years
- staying in intensive care unit for at least 4 days
Exclusion Criteria:
- anuria
- intestinal insufficiency (obstruction, discontinuation of intestine or severe ileus)
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT00875797
| Slovenia | |
| General Hospital Slovenj Gradec | |
| Slovenj Gradec, Slovenia | |
| Principal Investigator: | Jasna Uranjek, MD | General Hospital Slovenj Gradec |
More Information
Publications:
| Responsible Party: | Lidija Kompan, MD, PhD, University Medical Centre Ljubljana |
| ClinicalTrials.gov Identifier: | NCT00875797 History of Changes |
| Other Study ID Numbers: | P4-0092: onko |
| Study First Received: | April 2, 2009 |
| Results First Received: | June 27, 2013 |
| Last Updated: | December 1, 2013 |
| Health Authority: | Slovenia: Ethics Committee |
Keywords provided by University Medical Centre Ljubljana:
|
enteral parenteral glutamine intestinal permeability infection |
Additional relevant MeSH terms:
|
Critical Illness Disease Attributes Pathologic Processes |
ClinicalTrials.gov processed this record on February 25, 2015