Role of Glutamine Supplemented Total Parenteral Nutrition (Tpn) in Severe Acute Pancreatitis

Aims and objectives: We conducted this study to evaluate the role of glutamine supplemented total parenteral nutrition (TPN) in severe acute pancreatitis. Methods: Forty patients with severe acute pancreatitis admitted at Rajendra institute of medical Sciences ,Ranchi, over a period of one year( July 2012 to June 2013) were randomly divided into two therapeutic groups. Patients in group 1( 19 in no) and group 2 (21 in no.) were treated with standard TPN and glutamine supplemented TPN respectively. Patients were assessed for nutritional parameters, the incidence of complications, mortality, length of hospital stay(LOS) and length of TPN. Results: Majority of patients were male in both groups(60 % in group 1 vs. 62% in group 2) and the average age of presentation was also same(41.13+ 4.46 years in group 1 vs.39+3.96 years in group 2). Gall stone was the most common etiological factor followed by alcohol. The incidence of complications in group 1 was much higher(40.25%) than those in group 2 (30%). Mortalities for group 1 and 2 were 15.78 %(3/19) and 9.52%(2/21) respectively. The length of hospital stay in group 1(21.08+2.80days) was longer than those of group 2 (19.33+2.62 days). The length of TPN was alsolonger in group 1 (14.47+2.72 days) than those of group 2 (10.56+2.21 days). Conclusion: Glutamine supplemented TPN did not significantly decrease the mortality or rate of complications but it reduced the number of hospital days admission and duration of TPN. Further studies with large number of patients is needed in Indian setting.