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A combination therapy consisting of the amino acid glutamine and the synthetic colloid hydroxyethyl starch (HES), typically administered in a saline solution for fluid resuscitation. Hydroxyethyl starch serves as a volume expander to maintain intravascular oncotic pressure and improve microcirculation, particularly in conditions like severe acute pancreatitis (SAP) where capillary leak is prevalent. Glutamine, often administered as a dipeptide (e.g., N(2)-L-alanyl-L-glutamine), provides essential metabolic support for rapidly dividing cells such as enterocytes and leukocytes. This combination is designed to mitigate systemic inflammatory response syndrome (SIRS), reduce levels of pro-inflammatory cytokines (TNF-alpha, IL-8), and preserve the intestinal mucosal barrier, thereby preventing bacterial translocation and endotoxemia.
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