الفهرس 
Pathophysiology of burn shockOnly 14 pages are availabe for public view
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Abstract
The burn patient presents special challenges regarding resuscitation requirements, metabolic stress and pattern of complications. Burn-related infection has remained high incidence despite different preventive modalities. Topical antibacterial agents, early excision of eschar, and timely closure of burn wound have been demonstrated to significantly reduce the occurrence of invasive burn wound infection and its related mortality. (48)
Glutamine is a nonessential amino acid that can become conditionally essential under catabolic states such as critical illness and burns. It is synthesized predominantly in muscle but also in small amounts by the lung and brain. It plays a role as a fuel source for enterocytes, lymphocytes, and other rapidly dividing cells of the immune system. (2)
Although glutamine comprises 10-20% of dietary protein, no net absorption occurs as it undergo significant metabolism in the enterocyte, serving as a major respiratory fuel. Several studies have shown that in catabolic patients, the endogenous production of muscular glutamine is increased while the plasma levels are decreased, indicating elevated glutamine needs. Studies have shown that low plasma glutamine values on admission are related to increased mortality. (4)
These findings are the reason for the use of glutamine supplementation in the ICU patients to meet the demand for protein synthesis, modulation of the immune system, reduction of oxidative stress, and preservation of the gut barrier. (114)
The present study was carried out to evaluate the effect of parenteral glutamine supplementation on prevention of infection in burn patients and to show the impact of the parenteral glutamine supplementation on sepsis outcome, ICU and hospital-stay in patients with burns.
The study was carried out in ICU unit in Menoufia university hospital on 60 burn patients. Patients were randomly categorized into two equal groups (30 each) by using closed envelope technique. group I; these patients were received 0.5 gm/kg/day IV glutamine infusion as a part of their nutrition for 7 days after ICU admission. group (II); control group was received IVI of normal saline equivalent to volume of glutamine.