Glutamine in severe burn injury

Severe burn injury is a major global medical and social challenge associated with high mortality rates, primarily due to sepsis and multiple organ failure. Burn disease induces a persistent hypermetabolic response characterized by pronounced protein and energy deficiency, loss of muscle mass, and marked glutamine depletion. Glutamine is a conditionally essential amino acid in critical illness. It is crucial in maintaining immune cell function, intestinal barrier integrity, antioxidant defense, and modulation of systemic inflammation. This review analyzes the pathophysiology of glutamine deficiency, mechanisms of its action, and the results of clinical studies, including pilot trials and meta-analyses. Conflicting data regarding the potential harm of high-dose glutamine administration in related populations of critically ill patients (REDOXS, METAPLUS trials) are discussed. The safety and efficacy of enteral glutamine at a dose of 0.5 g/kg×day in patients with severe burns are detailed. The use of glutamine as part of comprehensive therapy in patients with burn injury is pathogenetically justified. It contributes to a reduction in infectious complications, shortens hospital length of stay, and may have a beneficial effect on survival.