Synopsis

Source of validity: Scientific
Rating (out of 5): 4

L-Alanyl-Glutamine is a dipeptide composed of the amino acids L-alanine and L-glutamine, designed to provide a stable and soluble form of glutamine for intravenous or enteral nutrition. Its use in supporting patients recovering from surgery is primarily grounded in scientific research. Glutamine is considered a "conditionally essential" amino acid during periods of metabolic stress, such as trauma, surgery, burns, or critical illness, when endogenous synthesis may not meet increased demands.

Several randomized controlled trials and meta-analyses have investigated the impact of glutamine supplementation, often in the form of L-alanyl-glutamine, on surgical outcomes. The evidence suggests that L-alanyl-glutamine supplementation can help maintain gut integrity, reduce infection rates, and improve nitrogen balance in patients undergoing major surgery, particularly gastrointestinal operations. Clinical guidelines, such as those from the European Society for Clinical Nutrition and Metabolism (ESPEN), recommend glutamine-supplemented parenteral nutrition for surgical and critically ill patients when enteral feeding is not feasible.

However, while the majority of studies indicate benefits in terms of reduced infectious complications and shorter hospital stays, the impact on mortality is less clear. Large clinical trials in critical care settings have shown mixed results, and some recent studies suggest caution in unselected critically ill populations. Nevertheless, for postoperative surgical patients—especially those with major abdominal surgery—the scientific evidence supporting L-alanyl-glutamine is robust, justifying its use in appropriate clinical contexts.

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