Clinical Observation Of Glutamine In The Treatment Of Critically Ill Patients

Objective:To study the effect of parenteral nutrition supplementation with glutamine on inflammatory response,liver and kidney function,nutritional status,infection-related complications and clinical prognosis in critically ill patients.Methods:A retrospective analysis of 102 critically ill patients who were admitted to the general intensive care unit and emergency intensive care unit of the Second Affiliated Hospital of Nanchang University from October 2019 to January 2021 and met the standards.The patients were divided into 63 cases in the glutamine(GLN)group and39 cases in the non-glutamine group.All patients in the group were given special care from the intensive care unit team,active treatment of the primary disease,symptomatic supportive treatment,and energy support.The GLN group was treated with glutamine 0.5g/kg once a day and intravenous infusion on the basis of its treatment.The vital signs,inflammatory indexes,liver function,renal function,and incidence of infection complications,days of hospitalization,APACHEⅡ score,hospitalization expenses,28-day mortality rate,etc.were recorded when the two groups of patients were admitted to the hospital and 1,3,and 7 days after treatment.The software SPSS26.0 was used for statistical analysis to compare the immune function and clinical prognosis of the two groups of patients when they were admitted to the hospital and after 1,3,and 7 days of treatment,and analyze the effect of parenteral nutrition with glutamine on critically ill patients.Results:1.By analyzing the experimental data,it can be concluded that there is no statistical difference between the two groups of patients in terms of age,gender,disease composition,vital signs,inflammation indicators,liver and kidney function,disease severity,etc.at the time of admission(p>0.05).2.The above indicators of the two groups of patients did not change significantly after 1 day of treatment,and the difference between the groups was not statistically significant(p>0.05).3.After 3days of treatment,the levels of C-reactive protein in the two groups were higher than those at admission,and the increase in the non-GLN group was more obvious.The difference between the two groups was statistically significant(p<0.05).4.After 7days of treatment,the heart rate,C-reactive protein,procalcitonin,and white blood cell counts of the GLN group decreased significantly,and the difference was statistically significant compared with the non-GLN group(p<0.05).The total bilirubin,aspartate aminotransferase,and creatinine of the two groups of patients were higher than those on admission,but the increase was more obvious in the non-GLN group,and the difference between the two groups was statistically significant(p<0.05).The total protein,albumin,and lymphocyte counts of the two groups were higher than those at admission,and the GLN group increased more significantly.The difference between the two groups was statistically significant(p<0.05).After treatment,the APACHEII scores of patients in the GLN group decreased when they were transferred to another department or died.Compared with the time when they were admitted to the hospital,the difference was statistically significant(p<0.05).The length of ICU stay in the GLN group was shorter than that in the non-GLN group,and the cost of hospitalization was lower.The difference between the two groups was statistically significant(p<0.05).Conclusion:Parenteral supplementation of glutamine may be able to reduce the impact of the disease on the liver and kidney function of critically ill patients by regulating the body’s immunity,alleviating the stress response,reducing the impact of the disease on the liver and kidney function of critically ill patients,improving the nutritional status,and shortening the patient’s ICU stay in.