Effects of enteral nutrition with glutamine on nutritional status and immune function in eldely critically ill patients

Objective: To study the effects of enteral nutrition with glutamine on nutritional status and immune function in eldely critically ill patients. Methods: Ninety critically ill patients were randomly divided into three group: total parenteral nutrition without glutamine group( group A),enteral nutrition with low and high glutamine( 0. 3 g / kg·d and 0. 6 g / kg·d) groups( group B and C). The fasting blood sample were collected before seventh and fouteenth day after nutritional support. Serum diamine oxidase( DAO) and glutamine( Gln),transferin( TF),prealbumin( PA),hemoglobin( Hb),albumin( ALB),immunoglobulin( IgA,IgM,IgG),T lymphocyte subsets( CD4+,CD8+,CD4+/ CD8+) were measured. Results: The serum levels of Gln in group B and C were significantly higher than those in group A( P 0. 05),The serum levels of DAO in group B and C were significantly less than those in group A( P 0. 05). Nutritional status increased in three groups. Immunoglobulin and T lymphocyte subsets levels in group C were significantly higher than the other two groups( P 0. 01). Conclusion: Enteral nutrition with increased glutamine can improve intestinal mucosa barrier and nutritional status in elderly critically ill patients,especially with high doses of glutamine.