Which statement best describes enteral glutamine supplementation in critically ill patients not in multi-organ failure?

• A. Enteral glutamine is preferred over parenteral.
• B. Glutamine has not been shown to reduce length of stay.
• C. Glutamine reduces systemic inflammation.
• D. Glutamine has been shown to reduce mortality.

Answer: (B)

Glutamine is studied in critical illness as a nutrient to support gut integrity and immune function, but in patients who are critically ill without multi-organ failure, enteral glutamine has not reliably shortened hospital stay. Large randomized trials and reviews have not shown a consistent reduction in length of stay with this supplementation, and mortality benefits have not been demonstrated in this population either. Some studies hint at possible reductions in infections or other outcomes in certain subgroups, but these findings are not consistent enough to claim an overall LOS or mortality benefit.

The other statements aren’t as consistently supported by the broader evidence. There isn’t a clear, universal preference for enteral over parenteral glutamine in this setting, since route choice depends on the overall nutrition plan and GI function. Glutamine’s effect on systemic inflammation is variable and not reliably proven as a consistent intervention. And a reduction in mortality has not been demonstrated in this population.