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Enteral glutamine supplementation in burn patients: a systematic review and meta-analysis of randomized controlled trials
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  • Muhammad Ehsan,
  • Muhammad Abdullah Ilyas,
  • Farwa Athar,
  • Aiman Naveed,
  • Huzaifa Cheema,
  • Muhammad Ayyan,
  • Ayesha Hussain,
  • Aqeeb Ur Rehman,
  • Biah Mustafa,
  • Aamna Badar,
  • Muhammad Umer,
  • Abia Shahid,
  • Sarya Swed,
  • Rehmat Ullah Awan,
  • Chinmay Jani,
  • Harpreet Singh
Muhammad Ehsan
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Muhammad Abdullah Ilyas
King Edward Medical University
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Farwa Athar
King Edward Medical University
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Aiman Naveed
King Edward Medical University

Corresponding Author:aimannaveed23@gmail.com

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Huzaifa Cheema
King Edward Medical University
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Muhammad Ayyan
King Edward Medical University
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Ayesha Hussain
King Edward Medical University
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Aqeeb Ur Rehman
King Edward Medical University
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Biah Mustafa
King Edward Medical University
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Aamna Badar
King Edward Medical University
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Muhammad Umer
King Edward Medical University
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Abia Shahid
King Edward Medical University
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Sarya Swed
Aleppo University Hospital
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Rehmat Ullah Awan
Ochsner Health
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Chinmay Jani
University of Miami Health System
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Harpreet Singh
Medical College of Wisconsin
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Abstract

Background: Glutamine is essential for various metabolic processes and is a fundamental component in mechanisms involved in cellular resistance against injury and mortality. However, the specific impact of enteral glutamine administration on burn patients remains uncertain. We performed this meta-analysis to establish glutamine’s role in managing burn injury patients. Methods: We conducted a comprehensive search across multiple electronic databases, including MEDLINE (via PubMed), Embase, and various trial registries, to identify randomized controlled trials that evaluated the effectiveness of enteral glutamine in burn patients. To analyze the data, we employed a random-effects model and presented dichotomous outcomes and continuous outcomes as relative risk and mean difference, along with corresponding 95% confidence intervals, respectively. Results: Our meta-analysis included 6 RCTs involving 1413 patients. Our primary outcome, all-cause mortality, was reported by 5 studies and was found to be comparable between the glutamine and control groups (RR=0.66, 95% CI=0.22-1.94). There was no significant difference between the glutamine and control group regarding the incidence of infection (RR=0.93, 95% CI=0.67-1.30) and length of hospital stay (MD -4.76 days, 95% CI=-10.63 to 1.11 days). Conclusion: The enteral administration of glutamine does not decrease mortality in burn patients. Further high-quality, large-scale randomized controlled trials are needed to provide conclusive evidence.