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Trial of Enteral Glutamine on Intestinal Permeability in Critically Ill Patients

Phase 3
Completed
Conditions
Critical Illness
Enteral Nutrition
Intestinal Permeability
Interventions
Drug: Glutamin
Other: Maltodextrin
Registration Number
NCT03113240
Lead Sponsor
Shahid Beheshti University
Brief Summary

Glutamine-induced recovery in intestinal barrier function by reducing bacterial translocation was demonstrated in previous studies. In this trial, intensive care unit patients with enteral feeding will receive either enteral glutamine or maltodextrin as placebo for 10 days and the effects of the intervention on intestinal permeability will be assessed.

Detailed Description

A randomized, double blind, controlled trial will be conducted in general intensive care unit (ICU) in Tehran, Iran. After a full review of the inclusion and exclusion criteria and explanation of the risks and benefits of the study, written consent form will be completed. The participants are 60 eligible hospitalized patients with enteral feeding in ICU, aged ≥ 18 years. Intervention patients will be received 0.3 g/kg/day of glutamine along with enteral formula for 10days and control patients will be received maltodextrin along with enteral formula for 10 days. Patients will be evaluated for plasma endotoxin and plasma zonulin.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Adult patients (>18 years old) admitted to ICU
  • Start of study intervention within 48 hours after ICU admission
  • Expected to require enteral nutrition for at least 72 hours aiming for full enteral nutrition and receive at least 80 percent of enteral formula during the first 48 hour
  • Written informed consent of patient or written informed consent of legal representative
Exclusion Criteria
  • Enrollment in a related ICU interventional study
  • Requiring other specific enteral nutrition for medical reason
  • Death or Discharge before 5th day
  • Having any contra-indication to receive enteral nutrition
  • Pregnant patients or lactating with the intent to breastfeed
  • BMI <18 or > 40.0 kg/m2
  • Have life expectancy of <6 mo
  • Patients who are moribond
  • Liver cirrhosis- Child's class C liver disease
  • Have seizure disorder requiring anticonvulsant
  • History of allergy or intolerance to the study product components
  • Receiving glutamine during two weeks before start study product
  • Have other reasons

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
GlutaminGlutaminIntervention patients will be received enteral formula and glutamine 0.3 g/kg/day given via nasogastric tube as boluses q 4hrs.
maltodextrinMaltodextrinControl patients will be received enteral formula and maltodextrin mixed in with water and given via nasogastric tube as boluses q 4hrs.
Primary Outcome Measures
NameTimeMethod
Maximum plasma endotoxin concentrationbaseline, Day 5, Day 10

The levels of plasma endotoxin

Maximum plasma antiendotoxin IgG and Ig M concentrationbaseline, Day 5, Day 10

The levels of plasma antiendotoxin IgG and Ig M concentration

Maximum plasma zonulin concentrationbaseline, Day 5, Day 10

The levels of plasma zonulin

Secondary Outcome Measures
NameTimeMethod
Mortality in ICUDay 10

Mortality rate in ICU

Length of stay in ICUDay 10

Duration of stay in ICU

Gastrointestinal complicationDay10

abdominal distention, vomiting, diarrhea and constipation

Severe sepsisDay 10

according to the American College of Chest Physicians and the Society of Critical Care Medicine

Trial Locations

Locations (1)

Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital

🇮🇷

Tehran, Iran, Islamic Republic of

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