Background Studies evaluating intravenous (IV) glutamine supplementation in critically ill patients have shown inconsistent results. This study aimed to evaluate the effects of IV glutamine on mortality, infectious complications, length of stay, and duration of mechanical ventilation. Methods: A systematic search of Ovid Medline, Embase, the Cochrane Central Register of Controlled Trials, and KoreaMed was conducted from inception through October 2023 and updated in April 2025. Randomized controlled trials comparing IV glutamine supplementation with standard care in critically ill adults were included. Pooled estimates were calculated using random-effects models. Results: A total of 10 randomized trials involving 1,593 critically ill patients were included in the analysis. IV glutamine supplementation was not associated with reduced overall mortality (risk ratio [RR], 0.93; 95% CI, 0.77–1.13) or overall infection rates (RR, 0.86; 95% CI, 0.63–1.18). No mortality benefit was observed in either non-surgical or surgical/trauma subgroups. Glutamine supplementation was associated with reduced pneumonia incidence (RR, 0.65; 95% CI, 0.49–0.87) and shorter mechanical ventilation duration (mean difference, −0.97 days; 95% CI, −1.62 to −0.32); however, these findings were based on a limited number of small studies. Intensive care unit and hospital length of stay were longer in the glutamine group. Conclusions: IV glutamine supplementation was not associated with improved survival or overall infection rates in critically ill adults. Current evidence does not support routine IV glutamine supplementation in unselected critically ill patients.
Background Sepsis and septic shock remain the leading causes of death in critically ill patients worldwide. Various biomarkers are available to determine the prognosis and therapeutic effects of sepsis. In this study, we investigated the effectiveness of presepsin as a sepsis biomarker.
Methods Patients admitted to the intensive care unit with major or minor diagnosis of sepsis were categorized into survival and non-survival groups. The white blood cell count and serum C-reactive protein, procalcitonin, and presepsin levels were measured in all patients.
Results The study included 40 patients (survival group, 32; non-survival group, 8; mortality rate, 20%). The maximum serum presepsin levels measured during intensive care unit admission were significantly higher in the non-survival group (median [interquartile range]: 4,205.5 pg/ml [1,155.8–10,094.0] vs. 741.5 pg/ml [520.0–1,317.5], P<0.05). No statistically significant intergroup differences were observed in the maximum, minimum, and mean values of the white blood cell count, as well as serum C-reactive protein, and procalcitonin levels. Based on the receiver operating characteristic curve, the area under the curve for presepsin as a predictor of sepsis mortality was 0.764. At a cut-off value of 1,898.5 pg/ml, the sensitivity and specificity of presepsin for prediction of sepsis-induced mortality were 75.0% and 87.5%, respectively.
Conclusions Early diagnosis of sepsis and prediction of sepsis-induced mortality are important for prompt initiation of treatment. Presepsin may serve as an effective biomarker for prediction of sepsis-induced mortality and for evaluation of treatment effectiveness.
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