Background
Although glutamine (GLN) is considered one of the pharmacological preconditioning proteins in cardiac surgeries, there is no consensus in literatures regarding the ideal time of administration. This randomized, double-blinded comparative study compared the effectiveness of GLN administration at two different time points in patients undergoing cardiopulmonary bypass.
Patients and methods
A total of 75 patients were randomly distributed into three equal groups: group 1 received GLN for 3 days preoperatively, group 2 received GLN at the day of surgery starting at the induction of anesthesia, whereas group 3, the control group, did not receive GLN.
Results
There was a significant decrease in troponin I at 6, 24, and 48 h (=0.03, 0.02, and 0.04, respectively), creatine kinase-MB at 24 and 48 h (=0.04 and 0.04, respectively), incidence of inotrope usage (=0.019), incidence of arrhythmias (=0.02), and ICU stay (=0.04), whereas significant increase in ejection fraction and blood pressure in GLN-treated groups (groups 1 and 2). The time of administration did not significantly affect the results between group 1 and group 2.
Conclusion
GLN enhances myocardial protection. The time of administration did not significantly affect the results, so administration at induction of anesthesia is well tolerated and feasible.