Early postoperative enteral nutrition with arginine-omega-3 fatty acids and ribonucleic acid-supplemented diet versus placebo in cancer patients
| Autor: | Volker Zumtobel, M. Kemen, Herbert Neumann, Heinz-Herbert Homann, Jurgen Windeler, Jurgen Baier, Anne-Kathrin Dauphin, Achim Mumme, M. Senkal |
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| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
Arginine biology business.industry Critical Care and Intensive Care Medicine Placebo Enteral administration Gastroenterology Surgery law.invention Parenteral nutrition Randomized controlled trial law Immunoglobulin M Internal medicine biology.protein Medicine Antibody business Prospective cohort study |
| Zdroj: | Critical Care Medicine. 23:652-659 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-199504000-00012 |
| Popis: | Objective: To evaluate the effect of early postoperative feeding with a nutritionally complete enteral diet supplemented with the nutrients arginine, ribonucleic acid (RNA), and ω-3 fatty acids on the immune function in patients undergoing surgery for upper gastrointestinal (GI) malignancies. Design: Prospective, randomized, placebo-controlled, double-blind study. Setting: Surgical intensive care unit (ICU) in a German university hospital. Patients: Forty-two consecutive patients receiving an enteral diet via needle catheter jejunostomy after GI surgery for cancer. Interventions: Patients were randomized to receive either the arginine, RNA, and ω-3 fatty acids supplemented diet or an isocaloric and isonitrogenous placebo diet. Early enteral nutrition was started on postoperative day 1 in the surgical ICU with 20 mL/hr and progressed to the optimal goal of 80 mL/hr by postoperative day 5. Measurements and Main Results: Clinical examination and adverse GI symptoms were recorded on a daily basis. Body weight was determined twice weekly. Immunoglobulin concentrations were determined by laser nephelometry. Interferon-γ concentrations were measured with a modified enzyme-linked immunosorbent assay method. Fluorescence-activated cell scan flow cytometry was performed to analyze B cells, T lymphocytes and their subsets. Clinical patient characteristics and mean caloric intake were similar between the two groups and both formulas were well tolerated. The number of T lymphocytes and their subsets, helper T cells (CD4) and activated T cells (CD3, HLA-DR), were significantly higher in the supplemented diet group on postoperative days 10 and 16 (p |
| Databáze: | OpenAIRE |
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