Meta-Analysis
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World J Crit Care Med. Feb 4, 2013; 2(1): 4-8
Published online Feb 4, 2013. doi: 10.5492/wjccm.v2.i1.4
Intravenous glutamine for severe acute pancreatitis: A meta-analysis
Xin Zhong, Cui-Ping Liang, Shu Gong
Xin Zhong, Cui-Ping Liang, Shu Gong, Hepato-bilio-pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zhong X and Liang CP contributed to the selection of studies and data extraction; All authors contributed to the study design, data analysis and interpretation of results, and reviewed the manuscript for important intellectual content and approved the final version.
Correspondence to: Shu Gong, MD, Hepato-bilio-pancreatic Surgery, West China Hospital, Sichuan University, People’s South Road No. 17, Chengdu 610041, Sichuan Province, China. joybell370@gmail.com
Telephone: +86-28-85422474 Fax: +86-28-85422474
Received: November 22, 2012
Revised: December 8, 2012
Accepted: December 23, 2012
Published online: February 4, 2013
Processing time: 154 Days and 15.1 Hours
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; Severe acute pancreatitis; Meta-analysis

Core tip: Glutamine dipeptide was given to patients with severe acute pancreatitis (SAP) in order to improve their nitrogen balance and immunonutrition. This meta-analysis aims to enhance our understanding of the clinical and economical validity of glutamine dipeptide for patients with SAP. We report the meta-analysis of four randomized controlled trials involving a total of 190 participants. Results showed that glutamine dipeptide has a positive effect in reducing the mortality rate, length of hospital stay, and the rate of complications. No serious adverse effects were found.