Early Enteral Nutrition in Critically III Patients With a High‐Protein Diet Enriched with Arginine, Fiber, and Antioxidants Compared With a Standard High‐Protein Diet. The Effect on Nosocomial Infections and Outcome

Caparros, T; Lopez, Jorge; Grau, T.

doi:10.1177/0148607101025006299

Cited by 101 publications

(101 citation statements)

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“…Higher albumin serum was demonstrated in the enriched formula group compared with standard formula. Caparros et al (2001) showed in critically ill patients with a diet enriched with arginine and fiber, a decrease in catheter-related sepsis rate. In our study with better nourished patients than those reported in previous studies, no differences were detected in postoperative infection complications, but wound complications were lower and plasma proteins improved with standard and immune-enhancing formula; we do not have a Arginine stimulates anabolic hormone release, improves survival in gut-derived sepsis and peritonitis by modulating bacterial clearance, and has been demonstrated to enhance natural killer cell cytotoxicity, increase T-cell proliferation, and accelerate wound healing (Reynolds et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

“…Although immune dysfunction could be multifactorial, the immune system may be modulated by specific nutritional substrates, such as arginine (Daly et al, 1998). There is evidence suggesting that enteral nutrition, supplemented with different agents including arginine and dietary fiber, improves immune function and reduces postoperative complications, in different groups of patients, such as those undergoing pancreatic surgery , surgery for stomach and colo-rectum cancer (Gianoti et al, 1999;Wu et al, 2001), and critically ill patients (Caparros et al, 2001). …”

Section: Introductionmentioning

confidence: 99%

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Postsurgery enteral nutrition in head and neck cancer patients

et al. 2002

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Objective: Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an arginineenriched diet, could improve nutritional variables as well as clinical outcomes. Design: Randomized clinical trial. Setting: Tertiary care. Subjects: A population of 47 patients with oral and laryngeal cancer were enrolled. Interventions: At surgery patients were randomly allocated to two groups: (a) patients receiving an enteral diet supplemented with arginine and fiber (group I); (b) patients receiving an isocaloric, isonitrogenous enteral formula (group II). Results: No significant intergroup differences in the trend of the three plasma proteins and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) of both formulas was good (17.4% group I and 8.3% group II; NS). During the 3 months after hospital discharge five patients died; no diferences were detected between groups (13% group I and 8.3% group II; NS). The incidences postoperative infection complications were similar (nine patients) in both groups (21.7% group I and 16.7% group II; NS). Fistula were less frequent in enriched nutrition group (0% group I and 20.8% group II; P < 0.05); wound infection was more frequent in group II, but without statistical difference (4.3% group I and 12.5% group II; NS). The length of postoperative stay was 22.8 AE 11.8 days in the enriched group and 31.2 AE 19.1 days in the control group (P ¼ 0.07). Conclusions: In conclusion, enriched formula improves local wound complications in postoperative head and neck cancer patients. Our results suggest that these patients could benefit from an immunonutrient-enhanced enteral formula.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postsurgery enteral nutrition in head and neck cancer patients

et al. 2002

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“…There were no differences in mortality or ICU and hospital length of stay 13 . Another study suggests that postoperative enteral nutrition with supplemental Arg, RNA, and omega-3 fatty acids instead of a standard enteral diet significantly improved immunologic, metabolic, and clinical outcomes in patients with upper gastrointestinal malignancies who were undergoing major elective surgery 14 .…”

Section: Essentialmentioning

confidence: 74%

“…Efron et al 9 Enhancing wound healing, regulating endocrine activity and potentiating immune activity Wu et al 8 Beneficial in improving reproductive, cardiovascular, pulmonary, renal, gastrointestinal, liver and immune functions, as well as facilitating wound healing, enhancing insulin sensitivity, and maintaining tissue integrity Daly et al 12 Enhancing or preserving immune function in high-risk surgical patients and theoretically improving the host's capacity to resist infection Caparrós et al 13 Significantly lower catheter-related sepsis rate…”

Section: Author Effect Of Supplementationmentioning

confidence: 99%

The importance and dosage of amino acids in nutritional support of various pathological conditions in ICU patients

Aimova¹,

Hronek²,

Zadák³

2014

BIOMED PAP

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Background. Normal adults require twenty L-amino acids (AA) for protein synthesis. Functional AA regulate key metabolic pathways that are necessary for maintenance, growth, reproduction and immunity. Dietary supplementation with one or a mixture of these AA may be beneficial for ameliorating health problems at various stages of the life cycle and for optimizing of the efficiency of metabolic transformations. During disease, other amino acids also become essential. The principal goal of protein/amino acid administration in various pathological conditions in intensive care unit (ICU) patients is to provide the precursors of protein synthesis in tissues with high turnover and to protect skeletal muscle mass and function. Amino acid requirements in parenteral nutrition (PN) are higher when the patient is stressed/ traumatized/infected than in the unstressed state. In severely ill ICU patients a higher provision of protein and amino acids has been associated with a lower mortality. Methods and Results. An overview of the effects and dosage of amino acids in nutritional support of various pathological conditions in ICU patients is presented. Conclusion. It was demonstrated that 2.0-2.5 g protein substrate/kg normal body weight/day is safe and could be optimal for the most critically ill adults to decrease the risk of morbidity and mortality in some pathological conditions.

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“…Other studies have shown that arginine increased lymphocytic interleukin-2 production and augmented lysis of tumours by macrophages . There is evidence suggesting that enteral nutrition, supplemented with different agents including arginine and dietary fibre, improves immune function and reduces postoperative complications, in different groups of patients such as pancreatic surgery , surgery of stomach and colo-rectum cancer (Gianoti et al, 1999;Wu et al, 2001), critically ill patients (Caparros et al, 2001) and head and neck cancer patients (Van Bokhorst-de van der Schueren et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Effect of c-reactive protein and interleukins blood levels in postsurgery arginine-enhanced enteral nutrition in head and neck cancer patients

et al. 2003

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Objective: It is known that the immune system is frequently affected in patients with head and neck cancer. Although immune dysfunction could be multifactorial, this immune system may be modulated by specific nutritional substrates, such as arginine. The aim of our study was to evaluate the effect of enteral nutrition supplemented with arginine on c-reactive protein (CRP), interleukin 6 (IL-6) and tumour necrosis factor (TNFa) in surgical head and neck cancer patients. Design: Randomized trial. Setting: Tertiary care. Subjects: A population of 36 patients with oral and laryngeal cancer were enrolled. Interventions: At surgery patients were randomly allocated to two groups: (a) patients receiving an enteral diet supplements with arginine and dietary fibre (group I, n ¼ 18); (b) patients receiving an isocaloric, isonitrogenous enteral formula (group II, n ¼ 18). Perioperatively and on postoperative day 5 the following parameters were evaluated: serum values of prealbumin, transferrin, albumin, total number of lymphocytes, interleukin 6, tumour necrosis factor a and c-reactive protein.Results: The mean age was 59.6 AE 10.9 y (two females=34 males). No significant intergroup differences in the trend of the three plasma proteins and weight were detected. CRP decreased in both groups (group I: 152.9 AE 76.9 vs 68.9 AE 82.5 mg=dl; P < 0.05; and group II: 105.9 AE 92 vs 43.6 AE 59.1 mg=dl; P < 0.05). Interleukin 6 did not change (group I: 16.3 AE 12.3 vs 35.6 AE 83.4 pg=ml; NS; and group II: 22.8 AE 40 vs 9.9 AE 17.7 pg=ml; NS). TNFa did not show any differences (group I: 4.6 AE 1.6 vs 5.1 AE 1.5 pg=ml; NS; and group II: 8.8 AE 6.1 vs 5.8 AE 1.7 pg=ml; NS). Lymphocytes increased in both groups (group I: 1405.6 AE 517 vs 1634 AE 529Â10 6 =ml; P < 0.05; and group II: 1355 AE 696 vs 1561 AE 541Â10 6 =ml; P < 0.05). Conclusions: Enhanced formula did not change IL6 and TNFa levels. Further studies are needed to determine whether route of nutrition or type of formula is the key in these patients.

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Early Enteral Nutrition in Critically III Patients With a High‐Protein Diet Enriched with Arginine, Fiber, and Antioxidants Compared With a Standard High‐Protein Diet. The Effect on Nosocomial Infections and Outcome

Cited by 101 publications

References 50 publications

Postsurgery enteral nutrition in head and neck cancer patients

Postsurgery enteral nutrition in head and neck cancer patients

The importance and dosage of amino acids in nutritional support of various pathological conditions in ICU patients

Effect of c-reactive protein and interleukins blood levels in postsurgery arginine-enhanced enteral nutrition in head and neck cancer patients

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