Duration of trial parenteral nutrition use
The median duration of trial parenteral nutrition was
5.1 days for glutamine formulation only, 4.1 days for
standard formulation plus selenium, 5.0 days for glutamine
formulation plus selenium, and 4.7 days for standard
formulation only.
Primary outcomes: new infections and mortality
New infections
Table 2 shows the results for the primary outcome
measures. Patients allocated to added selenium
showed a non-significant decrease in the rate of any
new infections in the next 14 days (126/251 (50%) for
selenium v 139/251 (55%) for no selenium, odds ratio
0.81 (95% confidence interval 0.57 to 1.15) P=0.24).
There was no evidence of any beneficial effect from
the glutamine formulation on new infections (134/
250 (54%) for glutamine v 131/252 (52%) for no glutamine,
odds ratio 1.07 (0.75 to 1.53) P=0.71). There was
no evidence of an interaction effect between glutamine
and selenium (odds ratio 0.98 (0.48 to 2.00) P=0.96).
The subgroup analyses showed no statistically significant
(1% level) interaction effects between the treatments
and the subgroups (fig 2).
When the definition of an infection was restricted to
the Centers for Disease Control criteria for confirmed
infections, results were similar to those for all new infections
for selenium (104/251 (41%) for selenium v 121/
251 (48%) for no selenium, odds ratio 0.75 (0.52 to 1.08)
P=0.12) and for glutamine, which had a higher number
(118/250 (47%) for glutamine v 107/252 (42%) for no
glutamine, odds ratio 1.23 (0.86 to 1.76) P=0.27). There
was no statistical evidence of an interaction between
treatments (odds ratio 1.28 (0.62 to 2.64) P=0.50).
Mortality
Mortality within the critical care or high dependency
units was slightly higher with glutamine formulations
compared with standard formulations (88/250 (35%)