Advancing care for burn patients | Queen’s Gazette

New research shows that glutamine, previously thought to help with burn injuries, does not increase time to discharge from the hospital.

head shot by Dr.  Heyland
dr Daren Heyland, director of the Clinical Evaluation Research Unit at Queen’s University and principal investigator and sponsor of the glutamine study.

Queens researcher Daren Heyland (Medicine) has spent his career studying which nutrients work best for critical care patients who are unable to eat for themselves and trying to understand if certain nutrients support their recovery. Patients in the intensive care unit who cannot feed themselves are artificially fed via a feeding tube or an intravenous catheter. For over 20 years, Dr. Heyland the role of glutamine, an endogenous amino acid found in foods such as fish, eggs and nuts.

Burn injuries are among the most expensive traumatic injuries to treat worldwide, and 50 percent of burn patients are treated with glutamine. Before this practice became more widely accepted, however, the medical community wanted more evidence of glutamine’s effectiveness.

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To understand the amino acid’s role in burn healing, Heyland was involved in a decade-long scientific study involving 1,200 severe burn patients worldwide. The study was recently published in the prestigious New England Journal of Medicine (NEJM) and was the first time a clinical trial of burn patients was featured in the prestigious publication. It produced some unexpected results – the glutamine didn’t appear to harm patients or help them with burns.

“In the past, small, single-center studies had indicated that glutamine is beneficial in the recovery of patients with severe burns. However, our previous work with glutamine in stressed, ill patients suggested that glutamine may actually be harmful in critically ill patients with organ failure. The only way to resolve this conflicting data was to conduct a large study evaluating glutamine in severe burns,” said Dr. Heyland.

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dr Heyland is director of the Clinical Evaluation Research Unit at Queen’s University, which acted as the coordinating center for the study. He also serves as principal investigator and sponsor of the study, working with over 60 burn departments in hospitals in nearly 20 countries.

“It took us 10 years to complete the study, including recruiting patients and securing funding,” said Dr. Heyland. “Hopefully, the results of this study will lead to units that have used glutamine ending this unnecessary practice.”

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The study was funded by the Canadian Institutes for Health Research and the US Department of Defense (DOD) through their competitive grant programs. About 20-30 percent of wounded soldiers have burns, and the Department of Defense is exploring new ways to treat burns.

The research of dr. Heyland to evaluate the use of diet or specific nutrients and their role in enhancing the recovery of critically ill patients is ongoing. With $1.5 million in new funding from the DOD, he’s now studying high-dose intravenous vitamin C in patients with burn injuries, which may help reduce the amount of fluid burns patients need to stay alive.