24809408
OBJECTIVE	The aim of this study is to evaluate the effect of oral glutamine ( GL ) supplementation on gut permeability and endotoxemia ( surrogate end point ) in patients with severe acute pancreatitis .
METHODS	In a randomized controlled trial , patients were randomized to be given placebo or GL for 7 days .
METHODS	The primary outcome measures include the effect on gut permeability ( assessed by lactulose/mannitol excretion in urine and endotoxemia assessed by endotoxin core antibodies type IgG and IgM ( EndoCab IgG and IgM ) .
METHODS	The secondary outcome measures include infectious complications , mortality , total hospital/intensive care unit stay , C-reactive protein , and prealbumin levels .
RESULTS	Patients were assigned to GL ( n = 41 ) and placebo ( n = 39 ) groups .
RESULTS	There was no change in gut permeability after the intervention .
RESULTS	However , the EndoCab IgM levels increased significantly ( 33 [ 4 , 175 ] to 40 [ 8 , 350 ] GMU/mL ; P = 0.0164 ) and the C-reactive protein levels decreased significantly ( 133 [ 1 , 287 ] to 88 [ 1 , 267 ] ng/mL ; P = 0.0236 ) in the GL group .
RESULTS	No difference was observed in infectious complication , prealbumin value , hospital/intensive care unit stay , and mortality in both groups .
CONCLUSIONS	No significant trend was identified for an effect of GL on gut permeability .
CONCLUSIONS	Decreased inflammation and endotoxemia did not translate into reduced infectious complications in severe acute pancreatitis .
CONCLUSIONS	However , the study was underpowered to detect the aforementioned difference ( trial registration : CTRI/2009/000945 ) .

