80 newborns and infants age ≤2 y requiring PN after major digestive tract surgery (GA ≥30 wk)
Randomized double-blind
Parenteral Gln; isonitrogenous isocaloric Gln (≤0.4 g/kg/d) supplemented PN started on d-2 after surgery and reached 90% of recommended AA intake of 1.5–2.5 g/kg/d (90% of Gln target dose of 0.4 g/kg/d) by d-4 until d-31, full EN, discharge or death; with tapering of PN started on or after d-6 ()
Standard PN started on d-2 after surgery and reached 90% of recommended AA intake of 1.5–2.5 g/kg/d by d-4 until d-31, full EN discharge or death, with tapering of PN started on or after d-6 ()
(1) Intestinal permeability (urinary lactulose/rhamnose ratio measured wk-1 through -4 after surgery, (2) nitrogen balance on d-4, -5, -6, urinary 3-MH excretion on d-5, mortality, LOS in ICU and in hospital, septic episodes, usage of antibiotics and ICU resources
(1) No effect on intestinal permeability, (2) no effect on nitrogen balance, urinary 3-MH excretion, mortality, LOS in ICU or in hospital, culture-proven sepsis, usage of antibiotics or ICU resources, and no adverse effects
20 neonates and infants aged <12 mo requiring PN after surgery for congenital or acquired gastrointestinal disease
Randomized double-blind
Enteral Gln; breastmilk or protein hydrolysate formula supplemented with enteral Gln (≤0.4 g/kg/d) until 7 consecutive d of full EN or hospital discharge ()
Breastmilk or protein hydrolysate formula supplemented with enteral iso-osmolar mix of nonessential AA (≤0.4 g/kg/d) until 7 consecutive d of full EN or hospital discharge ()
(1) Duration (d) on PN and d to achieve enteral feedings providing ≥80% of US-recommended dietary allowance for energy, (2) changes in macronutrient and energy absorption after supplementation, growth, and frequency of infections during trial
(1) No differences in d on PN or d to achieve ≥80% energy requirements by EN, (2) no improvement in energy absorption, no differences in frequency of infections, wt gain, length gain, or changes in anthropometric measures, safe
Enteral/parenteral Gln; enteral and/or parenteral glycyl-Gln powder (0.6 g/kg/d) for ~1..0 y or alanyl-Gln solution (0.3 g/kg/d) in combination with 3 wk rhGH and rehabilitative diet
None
Nutritional status and intestinal absorptive capacity after an average of y treatment
Increased wt, serum total protein, albumin, hemoglobin, reduced stool frequency and stool nitrogen, increased D-xylose absorption
37 patients aged 9–74 y with SBS (including 6 children aged 9–13 y)
Case series
Enteral Gln; oral Gln powder (0.6 g/kg/d) for 1-2 y in combination with rhGH (0.05 mg/kg/d) for 3 wk and rehabilitative diet
None
Efficacy in weaning off PN, intestinal absorptive capacity (D-xylose absorption, stool frequency, stool nitrogen) and plasma protein concentrations after 2-3 y of treatment
Improved intestinal absorptive capacity and increased plasma protein concentrations, 57% of patients weaned off PN
15 children aged 6.8–15.7 y with active Crohn’s disease
Randomized double-blind
Enteral Gln, polymeric EN with 42% of AA content as Gln for 4 wk ()
Isocaloric isonitrogenous exclusive standard polymeric EN with identical essential AA and 4% of AA content as Gln for 4 wk ()
Plasma antioxidant concentrations after 4 wk exclusive EN
Increased plasma selenium concentrations (both groups), decreased concentrations of vitamin C and E (both groups), no change in vitamin A, urates, glutathione, and malondialdehyde
PN: parenteral nutrition; EN: enteral nutrition; wt: weight; GA: gestational age; AA: amino acid; 3-MH: 3-methyl-histidine; LOS: length of stay; ICU: intensive care unit; SBS: short bowel syndrome; rhGH: recombinant growth hormone; SC: subcutaneous; IGF-1: insulin-like growth factor-1; MUAC: mid upper arm circumference.
*Originating from the same cohort.
