Nutrición Hospitalaria 00519 / http://dx.doi.org/10.20960/nh.519

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Oral glutamine reduces myocardial damage after coronary revascularization under cardiopulmonary bypass. a randomized clinical trial

Mariana Chávez Tostado, Fernando Carrillo-llamas, Porfirio Eduardo Martínez-gutiérrez, Araceli Alvarado-ramírez, Jaime Gilberto López-taylor, José Clemente Vásquez-jiménez, Clotilde Fuentes-orozco, Jorge Rendón-félix, Leire Irusteta-jiménez, Vanessa Carolina Calil-romero, José Antonio Ramírez-jiménez, Luis Rodrigo Michel-espinoza, Carmen Karina Contreras-lópez, Lizbeth Araceli Cuesta-márquez, Alejandro González-ojeda

VOLUMEN 34, NÚM. 2, marzo-abril (2017), PAG. 277-283

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Background: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers.Methods: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation. Patients were randomly assigned to receive oral glutamine (0.5 g/kg/day) or maltodextrin 3 days before surgery. Cardiac injury markers as troponin-I, creatine phosphokinase, and creatine phosphokinase-Mb were measured at 1, 12, and 24 hours postoperatively.Results: At 12 and 24 hours serum markers levels were significantly lower in the glutamine group compared with controls (p = 0.01 and p = 0.001, respectively) (p = 0.004 and p < 0.001, respectively). Overall, complications were significantly lower in the glutamine group (p = 0.01, RR = 0.54, 95% CI 0.31-0.93). Mortality was observed with 2 cases of multiple organ failure in control group and 1 case of pulmonary embolism in glutamine group (p = 0.50).Conclusion: Preoperative oral glutamine standardized at a dose of 0.5 g/kg/day in our study group showed a significant reduction in postoperative myocardial damage. Lower cardiac injury markers levels, morbidity and mortality were observed in patients receiving glutamine.

Palabras Clave: Glutamine. Cardiac surgery. Cardiopulmonary bypass. Troponin-I. CPK. CPK-Mb.

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Bibliografía

Norouzi, Mona, Nadjarzadeh, Azadeh, Maleki, Majid, Khayyatzadeh, Sayyed Saeid, Hosseini, Saeid, Yaseri, Mehdi, Fattahi, Hamed (2022) The effects of preoperative supplementation with a combination of beta‐hydroxy‐beta‐methylbutyrate, arginine, and glutamine on inflammatory and hematological markers of patients with heart surgery: a randomized controlled trial. BMC Surgery

F. Mostafa, Mohamed, Ahmad Ibrahim Elmorabaa, Hany, Mahmoud Mostafa, Mohammed, Mostafa Abd El Gawad, Ramy, Ismail Seddik, Mohamed, Herdan, Ragaa, Hassanien Bakr, Mostafa, Zarief Kamel, Emad (2023) Effects of preoperative intravenous glutamine administration on cardiac and renal functions in patients undergoing mitral valve replacement surgeries: A randomized double-blind controlled trial. Egyptian Journal of Anaesthesia

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Ferron, Marine, Denis, Manon, Persello, Antoine, Rathagirishnan, Raahulan, Lauzier, Benjamin (2019) Protein O-GlcNAcylation in Cardiac Pathologies: Past, Present, Future. Frontiers in Endocrinology

Nakamura, Kensuke, Yamamoto, Ryo, Higashibeppu, Naoki, Yoshida, Minoru, Tatsumi, Hiroomi, Shimizu, Yoshiyuki, Izumino, Hiroo, Oshima, Taku, Hatakeyama, Junji, Ouchi, Akira, Tsutsumi, Rie, Tsuboi, Norihiko, Yamamoto, Natsuhiro, Nozaki, Ayumu, Asami, Sadaharu, Takatani, Yudai, Yamada, Kohei, Matsuishi, Yujiro, Takauji, Shuhei, Tampo, Akihito, Terasaka, Yusuke, Sato, Takeaki, Okamoto, Saiko, Sakuramoto, Hideaki, Miyagi, Tomoka, Aki, Keisei, Ota, Hidehito, Watanabe, Taro, Nakanishi, Nobuto, Ohbe, Hiroyuki, Narita, Chihiro, Takeshita, Jun, Sagawa, Masano, Tsunemitsu, Takefumi, Matsushima, Shinya, Kobashi, Daisuke, Yanagita, Yorihide, Watanabe, Shinichi, Murata, Hiroyasu, Taguchi, Akihisa, Hiramoto, Takuya, Ichimaru, Satomi, Takeuchi, Muneyuki, Kotani, Joji (2025) The Japanese Critical Care Nutrition Guideline 2024. Journal of Intensive Care

Drăgan, Anca, Drăgan, Adrian Ştefan (2024) The Preventive Role of Glutamine Supplementation in Cardiac Surgery-Associated Kidney Injury from Experimental Research to Clinical Practice: A Narrative Review. Medicina

Zhou, Tao, Yang, Yuqing, Chen, Qianming, Xie, Liang (2019) Glutamine Metabolism Is Essential for Stemness of Bone Marrow Mesenchymal Stem Cells and Bone Homeostasis. Stem Cells International

(2019) The Emerging Role of l-Glutamine in Cardiovascular Health and Disease. Nutrients

Yang, Liu, Xu, Longjin, Li, Juan, Wang, Huan, Sun, Jiahong, Yu, Ziqiang, Zhao, Xiaoqian, Zhao, Min, Xi, Bo (2022) The association of dietary glutamine supplementation with the development of high salt-induced hypertension in rats. Frontiers in Nutrition

Ahmad, Aya Hisham Moussa, Kamal Eldin, Farouk, Rashed, Mohamed Mohsen (2023) Efficacy of Perioperative Infusion of N(2)-L-alanyl-L-glutamine in Glycemic Control for Patients With Uncontrolled Diabetes Mellitus Presented for Urgent Coronary Artery Bypass Surgery: A Randomized Controlled Trial. Journal of Cardiothoracic and Vascular Anesthesia

Okur, Özkan, Diniz, Gülden, Arslan, Oğuz Alp, Can, Mehmet, Evciler, Hüseyin, Oral, Akgün, Hoşgör, Münevver (2022) L-glutamine Supplemented Nutrition Alleviates Damage Caused by Corrosİve Esophagitis in Rats. Journal of Dr Behcet Uz Children s Hospital

Naspitz, Laura, Konstantyner, Tulio (2020) Efeitos e segurança do uso pré-operatório de glutamina ou Whey Protein: Uma revisão sistemática. International Journal of Nutrology

Correia, Cláudia, Wang, Qing-Dong, Linhardt, Gunilla, Carlsson, Leif G., Ulfenborg, Benjamin, Walentinsson, Anna, Rydén-Markinhutha, Katarina, Behrendt, Margareta, Wikström, Johannes, Sartipy, Peter, Jennbacken, Karin, Synnergren, Jane (2021) Unraveling the Metabolic Derangements Occurring in Non-infarcted Areas of Pig Hearts With Chronic Heart Failure. Frontiers in Cardiovascular Medicine

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