SIGNET

The Unit was part of a successful bid in securing a £1 million grant from the MRC for a Scottish multi centre randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients (SIGNET trial). This 42 month randomised controlled trial examined whether the addition of glutamine and/or selenium to parenteral nutrition improved patient outcomes and reduced the use of intensive care unit (ICU) and hospital resources. Infections in ICU are associated with a 2-3 times increased risk of death and systematic reviews suggested that supplementing parenteral nutrition (PN) in critical illness with glutamine or selenium could reduce infections and mortality.

The primary (intention to treat) analysis showed no effect on new infections or on mortality when parenteral nutrition was supplemented with glutamine or selenium. In a prespecified subgroup analysis, patients who received parenteral nutrition supplemented with selenium for ≥5 days did show a reduction in new infections.

Contacts

• Alison Avenell; a.avenell@abdn.ac.uk

Status

Publications

Andrews PJD, Avenell A, Noble DW, Campbell MK, Croal BL, Simpson WG, Vale LD, Battison CG, Jenkinson DJ, Cook JA and the SIGNET Trials group. Randomized trial of glutamine and/or selenium supplemented parenteral nutrition for critically ill patients.  BMJ 2011; 342: d1542.

Andrews PJ, Avenell A, Noble DW, Campbell MK, Battison CG, Croal BL, Simpson WG, Norrie J, Vale LD, Cook J, de Verteuil R, Milne AC.  Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007. Known as SIGNET (Scottish Intensive care Glutamine or selenium Evaluative Trial). BMC Trials 2007; 8: 25.