Enteral glutamine supplementation in burn patients: a systematic review and meta-analysis of randomized controlled trials

Background: Glutamine is essential for various metabolic processes and is a fundamental component in mechanisms involved in cellular resistance against injury and mortality. However, the specific impact of enteral glutamine administration on burn patients remains uncertain. We performed this meta-analysis to establish glutamine’s role in managing burn injury patients. Methods: We conducted a comprehensive search across multiple electronic databases, including MEDLINE (via PubMed), Embase, and various trial registries, to identify randomized controlled trials that evaluated the effectiveness of enteral glutamine in burn patients. To analyze the data, we employed a random-effects model and presented dichotomous outcomes and continuous outcomes as relative risk and mean difference, along with corresponding 95% confidence intervals, respectively. Results: Our meta-analysis included 6 RCTs involving 1413 patients. Our primary outcome, all-cause mortality, was reported by 5 studies and was found to be comparable between the glutamine and control groups (RR=0.66, 95% CI=0.22-1.94). There was no significant difference between the glutamine and control group regarding the incidence of infection (RR=0.93, 95% CI=0.67-1.30) and length of hospital stay (MD -4.76 days, 95% CI=-10.63 to 1.11 days). Conclusion: The enteral administration of glutamine does not decrease mortality in burn patients. Further high-quality, large-scale randomized controlled trials are needed to provide conclusive evidence.