The efficacy of early postoperative enteral immunonutrition on T-lymphocyte count: A randomised control study in low-risk cardiac surgery patients

Svetikiene, Marija; Ringaitienė, Donata; Veželienė, Jevgenija; Isajevas, Viktoras; Trybė, Dainius; Vicka, Vaidas; Malickaitė, Radvilė; Jurgauskienė, Laimutė; Norkūnienė, Jolita; Šerpytis, Mindaugas; Šipylaitė, Jūratė

doi:10.1016/j.clnu.2020.05.009

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…In this study, the incidence of postoperative complications in the observation is distinctively elevated versus the control, manifesting that postoperative ENT with Nutren is able to decline the incidence of complications. This might be associated with the fact that essential amino acids like Gln and arginine and other nutrients in Nutren are available to ameliorate the nutritional status of the body (Svetikiene et al, 2021). Nevertheless, the results have manifested that no distinct differences were in surgical efficacy between the two, clarifying that postoperative enteral nutrition exerts little influence on the therapeutic effect of CC radical resection, which is inconsistent with the results of foregoing studies (Xu et al, 2020).…”

Section: Discussionmentioning

confidence: 88%

“…Enteral nutrition support (ENS) refers to the nutritional support method that offers nutrients and other nutrients needed for metabolism via the gastrointestinal tract, being able to alleviate the phenomenon of poor nutrition in the body to a certain extent. Some scholars state that timely supplementation of glutamine (Gln) is available to effectively prevent intestinal barrier function damage (Svetikiene et al, 2021). Nutren, an enteral nutrition powder, primarily composed of indispensable amino acids involving Gln and arginine, as well as other nutrients like vitamins and minerals, which is prevalently adopted in postoperative ENS for multiple diseases, but its application value in ENT of CC after surgery was continuously in the exploratory stage.…”

Section: Introductionmentioning

confidence: 99%

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The influence of Nutren on postoperative nutritional status, inflammation and incision healing in patients with colon cancer

et al. 2022

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To explore the impact of Nutren on postoperative nutritional status, incision healing and inflammation in patients with colon cancer (CC). Division of 94 patients with CC as the research object was into the observation group (51 cases) and the control (43 cases) on the grounds of postoperative enteral nutrition support (ENS). Analysis of the influence of Nutren on postoperative nutritional status, inflammation and incision healing was performed. No distinct differences between the two groups in surgical efficacy, survival rate, distant metastasis rate and recurrence rate after surgery of 2 years (P > 0.05); The incision healing time of the observation was shorter versus the control, and the incision healing was superior versus the control. Hemoglobin, albumin and total plasma protein of 14 d after operation were elevated versus the control, and c-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6 were declined versus the control (P < 0.05). Giving of enteral nutrition support is to patients after CC radical resection, which is available to ameliorate the nutritional status, accelerate incision healing, and decline inflammation.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

The influence of Nutren on postoperative nutritional status, inflammation and incision healing in patients with colon cancer

et al. 2022

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“…A shorter hospitalization as well as reduced rates of infection were described when inspiratory muscle training, smoking and alcohol cessation, psychological therapies, weight loss, and preoperative immunonutrition were performed [ 46 ]. Thus, in terms of investing in research, clinicians and laboratory groups selected immunonutrition therapy in trauma and surgical patients, especially during the perioperative period [ 47 , 48 , 49 , 50 ]. Encouraging findings about the benefits of immunonutrition have been collected by cancer-related surgery [ 51 ], while studies on orthopedic and traumatic patients have been limited to date.…”

Section: Discussionmentioning

confidence: 99%

Immunonutrition in Orthopedic and Traumatic Patients

et al. 2023

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The role of nutrition intervention in surgical settings is constantly developing and evolving. Immunonutrition represents a viable option to reduce perioperative and postoperative complications in surgical oncology. However, as far as we know, little research has been conducted in the orthopedic field. With this review, we aim to summarize the state of the art in the application of immune-enhanced compounds to surgical, orthopedic, and traumatic patients. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were adopted. A comprehensive search was carried out using the PubMed (MEDLINE), EMBASE, and Cochrane Library databases. All the studies dealing with immunonutrition fed to traumatic and orthopedic patients were pooled, the data were extracted, and the studies were discussed. A total of eight studies were included: six focused on trauma surgery and two on elective orthopedic surgery. The epidemiological characteristics of participants and the assessment of results were reported. Data were analyzed using R software (2020; R Core Team). Based on the current available literature, a positive impact of immunonutrition in orthopedic and trauma surgical settings was registered. All studies analyzed showed the favorable impact of the immunonutrition diet on clinical outcomes. The full effect of this type of nutrition and its different applications in the orthopedic and traumatic fields should be critically investigated through more extensive randomized controlled trials.

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“…The study was conducted between February 2015 and June 2017 in a tertiary referral university hospital. The first data were published in our article [ 15 ]. Additional tests were performed on blood samples and examined expression of the CD69+ marker on T cells.…”

Section: Methodsmentioning

confidence: 99%

“…These effects are more prominent in patients who are already malnourished and “frail” before surgery. Our study recently revealed that postoperative supplementation of “fragile” low-risk cardiac surgery patients with immunonutrition for 5 days postoperatively was associated with significantly increased levels of both CD3+ and CD4+ T cells [ 15 ]. Although the biological relevance and clinical importance of these findings remains unclear, we conducted additional research.…”

Section: Introductionmentioning

confidence: 99%

Impact of Immunonutrition on T Cell Activation: A Randomized Control Study in Cardiac Surgery Patients

Svetikiene

Trybė

Strioga

et al. 2021

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Background. Cardiac surgery provokes an intense inflammatory response that can cause an immunosuppressive state and adverse postoperative outcomes. We recently showed that postoperative immunonutrition with glutamine in “fragile” low-risk cardiac surgery patients was associated with a significantly increased level of CD3+ and CD4+ T cells. In order to clarify the biological relevance and clinical importance of these findings, we investigated whether an increase in the CD4+ T cell level was caused by changes in the systemic inflammatory response (caused by surgery or infection) and if it was associated with their activation status.Methods. A randomized control study of low operative risk but “fragile” cardiac surgery patients was performed. Patients were randomized into immunonutrition (IN) and control groups (C). The IN group received normal daily meals plus special immune nutrients for 5 days postoperatively, while the C group received only normal daily meals. Laboratory parameters were investigated before surgery and on the sixth postoperative day and the groups were compared accordingly. The expression of the CD69+ marker was investigated to determine T cell activation status. Serum concentrations of cytokines (interleukin-10 (IL-10), tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6)) and C-reactive protein (CRP) were determined to assess the systemic inflammatory response, while procalcitonin (PCT) levels were evaluated to confirm or deny possible bacterial infection.Results. Fifty-five patients were enrolled in the study. Twenty-seven (49.1%) were randomized in the IN group. Results show that on the sixth postoperative day, the CD4+CD69+ and CD8+CD69+ counts did not differ between the IN and C groups, accordingly 0.25 [0.16–0.50] vs 0.22 [0.13-0.41], p=0.578 and 0.13 [0.06–0.3] vs 0.09 [0.05–0.14], p=0.178. Also, statistically significant differences were not observed in the cytokine levels (IN and C groups: TNF-α 8.13 [7.32–10.31] vs 8.78 [7.65–11.2], p=0.300; IL-6 14.65 [9.28–18.95] vs 12.25 [8.55–22.50], p=0.786; IL-10 5.0 [5.0–5.0] vs 5.0 [5.0–5.0], p=0.343 respectively), which imply that an elevated T cell count is not associated with the systemic inflammatory response. Also, PCT (IN and C groups: 0.03 [0.01–0.09] vs 0.05 [0.03–0.08], p=0.352) and CRP (IN and C groups 62.7 [34.2–106.0] vs 63.7 [32.9–91.0], p=0.840) levels did not differ between the two groups. Moreover, low levels of PCT indicated that the increase in T cell count was not determined by bacterial infection.Conclusions. Our findings showed that CD4+ T cell levels were associated with neither the systemic inflammatory response nor bacterial infection. Secondly, increases in T cells are not accompanied by their activation status. These results suggest a hypothesis that a higher postoperative T cell concentration may be associated with postoperative immunonutrition in low-risk cardiac surgery patients with intact cellular vitality, i.e. “fragile”. However, immunonutrition alone did not affect T cell activation status.

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The efficacy of early postoperative enteral immunonutrition on T-lymphocyte count: A randomised control study in low-risk cardiac surgery patients

Cited by 7 publications

References 26 publications

The influence of Nutren on postoperative nutritional status, inflammation and incision healing in patients with colon cancer

The influence of Nutren on postoperative nutritional status, inflammation and incision healing in patients with colon cancer

Immunonutrition in Orthopedic and Traumatic Patients

Impact of Immunonutrition on T Cell Activation: A Randomized Control Study in Cardiac Surgery Patients

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