Glutamine supplementation in multiple trauma of critical care

Glutamine is the most abundant amino acid in the body and has been considered nonessential in the past because it can be synthesized de novo. However, during stress and catabolic conditions such as multiple trauma and critical illness, the demand for glutamine increases and its concentration in plasma and muscle falls dramatically. Therefore, glutamine has been reclassified as an essential amino acid under such conditions. Parenteral glutamine supplementation in multiple trauma patients has been associated with reduced infectious complications, mortality, costs, and hospital length of stay. However, glutamine supplementation in multiple trauma patients receiving enteral nutrition and its best route are still controversial.Although glutamine supplementation is recommended, further well-designed multicenter trials are needed to provide a confirmed conclusion