Uncertainty about the safety of supplemental glutamine: an editorial on “A randomized trial of glutamine and antioxidants in critically ill patients”

Previously small randomized clinical trials and several meta-analyses have suggested improved patient outcomes from parenteral glutamine supplementation. A recent large multi-center randomized trial conducted in critically ill patients with documented multiple organ failure at enrollment demonstrated an increase in mortality among those receiving supplemental glutamine. This article discusses the discrepancies in trial outcomes and the risks associated with glutamine administration during critical illness.