Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma

Weimann, Arved; Bastian, L.; Bischoff, Werner; Grotz, M.; Hansel, M.; Lotz, Joachim; Trautwein, Christian; Tusch, Guenter; Schlitt, Hans J.; Regel, G.

doi:10.1016/s0899-9007(97)00429-2

Cited by 127 publications

(48 citation statements)

References 30 publications

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“…Taylor et al (1999) showed a decrease in CRP levels in head injury patients treated with an enhanced formula without differences in other biochemical parameters. These results were confirmed by Weimann et al (1998) in a group of multiple organ failure patients. Perhaps the differences among studies could be due to different treated patients and different nutrients in enhanced formulas.…”

supporting

confidence: 58%

Immunoenhanced enteral nutrition, effect on inflammatory markers in head and neck cancer patients

et al. 2004

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The aim of our study was to evaluate the effect of enteral nutrition supplemented with arginine in inflammatory markers in surgical head and neck cancer patients. A population of 29 patients with oral and laryngeal cancer were enrolled in a randomized trial. At surgery patients were randomly allocated to two groups: (a) patients receiving an enteral diet supplements with arginine (group I, n ¼ 14); (b) patients receiving an isocaloric, isonitrogenous enteral formula (group II, n ¼ 15). The mean age was 61.1710.8 y (five females/24 males). Characteristics of the patients on enrollment were similar for the two groups. Prealbumin and transferrin improved in both groups. c-reactive protein (CRP) levels decreased in both groups, (group I: 134.5762.5 vs 75.3751 mg/dl:Po0.05) and (group II: 103.6762 vs 43.8734.4 mg/dl:Po0.05). Interleukin-6 (IL-6) improved in both groups (group I: 20.35711.2 vs 6.773.1 pg/ml:Po0.05) and (group II:22.8740 vs 9.9717.7 pg/ml:ns). Tumoral necrosis factor alpha and lymphocytes did not change. In conclusion, both formulas improved IL-6 and CRP levels. Further studies are needed to determine whether type of formula is the key in these patients or genetic background play a main role in inflammatory response.

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supporting

confidence: 58%

Immunoenhanced enteral nutrition, effect on inflammatory markers in head and neck cancer patients

et al. 2004

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“…However, Taylor et al (1999) showed a decrease in CRP levels in head injury patients treated with an enhanced formula without differences in other biochemical parameters. These results were confirmed by Weimann et al (1998) in a group of multiple organ failure patients. Perhaps the differences among studies could be due to different treatment of patients and different nutrients in enhanced formulas.…”

Section: Discussionsupporting

confidence: 58%

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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“…These studies included evaluations of the experimental enteral formula in patients undergoing elective surgery, [27][28][29][31][32][33][34][35][36] critically ill patients with severe trauma, [38][39][40][41][42][43] critically ill patients in an ICU (Ross Products Division of Abbott Laboratories, unpublished data; 1996), 15,16,[44][45][46] and critically ill patients with severe burns. 37 The details of each study, including the methodological quality score, are described in Table 2 and TABLE 3.…”

Section: Effect Of Enteral Immunonutrition On Mortality Infectious Cmentioning

confidence: 99%

Should Immunonutrition Become Routine in Critically Ill Patients?

Heyland

Novák²,

Drover³

et al. 2001

JAMA

830

444

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Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma

Cited by 127 publications

References 30 publications

Immunoenhanced enteral nutrition, effect on inflammatory markers in head and neck cancer patients

Immunoenhanced enteral nutrition, effect on inflammatory markers in head and neck cancer patients

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

Should Immunonutrition Become Routine in Critically Ill Patients?

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