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Learning Objective 1: The learner will be able to learn methodology of mata-analysis to enhance the abilities of evidence-based practice.
Learning Objective 2: The learner will be able to know the importance of glutamine in parenteral nutrition in pancreatitis patients.
Glutamine, the most abundant free amino acid in the body, plays important role not only on nitrogen economic but on energy provision for enterocytes and cells of immune system. The treatment of pancreatitis frequently using parenteral nutrition as the main nutrients resource, yet, glutamine is not in the conventional parenteral nutrition preparation. There were meta-analysis of glutamine supplementary parenteral nutrition for post-operative or cancer patients, yet, there are few meta-analysis for pancreatitis patients. In addition, many studies had been conducted to evaluate efficacy of glutamine to pancreatitis patients, yet, diverse. The aim of this study is to evaluate efficacy of glutamine in pancreatitis patients through meta-analysis.
Methods:
A meta-analysis of relevant studies was retrieved by searching MEDLINE, EMBASE. The studies were included if they were random control trial, and were evaluated the efficacy of glutamine to pancreatitis patients. The studies were extracted and evaluate by two reviewers independently. Clinical outcomes of interests were nitrogen balance, infectious morbidity, length of hospital stay, length of TPN use, and mortality rate.
Results:
Six randomized control trials were included, with 202 patients involved. The combined results revealed that glutamine has a positive effect in decreasing infectious morbidity and mortality rate, improving nitrogen balance, and shortening length of hospital stay. Yet, there were, according combined results of this meta-analysis, Length of TPN use remained no significant. All of six studies showed, however, no serious adverse effect to participants.
Conclusion:
Glutamine supplement is beneficial to pancreatitis patient by decreasing infectious morbidity and mortality rate, improving nitrogen balance and shortening length of hospital stay.