While glutamine supplementation is not necessary for patients receiving EN, those on PN should be supplemented with 0.20 g/kg of L-glutamine daily.135,136 Studies have shown that glutamine supplementation in patients with AP has positive effects on serum albumin levels, CRP, infectious complications, length of hospital stay, and mortality.137-140 Apart from glutamine, immunonutrition has no established role in severe AP. This evidence concerns the gene ALB and alkaline phosphatase measurement.