The effect of glutamine supplementation in patients following elective surgery and accidental injury

J Nutr. 2001 Sep;131(9 Suppl):2543S-9S; discussion 2550S-1S. doi: 10.1093/jn/131.9.2543S.


The metabolic response to injury, whether a controlled elective surgical procedure or an accidental injury, is characterized by the breakdown of skeletal muscle protein and the translocation of the amino acids to visceral organs and the wound. At these sites, the substrate serves to enhance host defenses, and support vital organ function and wound repair. Glutamine (GLN) plays a major role in these processes, accounting for approximately one third of the translocated nitrogen. From available data, GLN-supplemented intravenous nutrition in patients undergoing elective surgery improves nitrogen balance, helps correct the decreased GLN concentration found in the free intracellular skeletal muscle amino acid pool and enhances net protein synthesis (particularly in skeletal muscle). Six randomized blind trials (two multicentered investigations) reported a decreased length in hospital stay in postoperative patients receiving GLN supplementation. After blunt trauma, GLN supplementation increased plasma concentrations, attenuated the immunosuppression commonly observed and decreased the rate of infection. Patients with burn injury have low GLN plasma and intramuscular concentrations; turnover and synthesis rate are accelerated, yet apparently inadequate to support normal concentrations. These data suggest that GLN supplementation has important effects in catabolic surgical patients, but the exact mechanisms to explain these events remain unknown, and more research is required to explain the apparent benefits of dietary GLN.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Burns / therapy
  • Clinical Trials as Topic
  • Dietary Supplements*
  • Elective Surgical Procedures*
  • Glutamine / blood
  • Glutamine / metabolism
  • Glutamine / therapeutic use*
  • Humans
  • Intestinal Mucosa / metabolism
  • Length of Stay
  • Muscle Proteins / biosynthesis
  • Muscle Proteins / metabolism
  • Muscle, Skeletal / metabolism
  • Nitrogen / metabolism
  • Nutritional Status
  • Parenteral Nutrition
  • Wound Healing
  • Wounds and Injuries / blood
  • Wounds and Injuries / metabolism
  • Wounds and Injuries / therapy*


  • Muscle Proteins
  • Glutamine
  • Nitrogen