 The patients who fulfilled the described criteria were randomly assigned to groups P or E using sequentially numbered containers for concealed randomization. Those in group P received the continuous infusion of parenteral glutamine dipeptide supplement Dipeptiven 100ml, Fresenius Kabi and were fed enterally with a standard commercial enteral polymeric diet without added glutamine Ensure, Abbott Ross. The patients in group E received the enteral glutamine supplement as continuous administration of a standard commercial enteral diet supplemented with glutamine Alitraq, Abbott Ross. The dose of the enteral glutamine, in a form of a free acid in this diet, depended on the volume of enteral food. Both groups of patients were treated with the glutamine supplement for five days. The other therapeutic procedures did not differ between the groups. All the patients were on continuous gastric feeding for 20 hours daily, starting with 20mlhour. The enteral nutrition was started in 24 hours following admission. The gastric residual was measured three times daily, and when less than 250ml, the feeding volume was gradually increased up to 100mlhour. If needed from day two onwards, the patients in all three groups received additional parenteral amino acid and glucose solutions to reach the goal 20kcalkgday and 0.15g nitrogenkgday. 