Research: CHUNTRASAKUL and colleagu

Listed in Issue 36

Abstract

CHUNTRASAKUL and colleagues, Research Center for Nutritional Support Siriraj Hospital, Thailand studied the nutritional, metabolic and immune effects of dietary amino acids and fish oil supplementation upon patients with compromised immune systems.

Background

Methodology

The authors conducted a prospective study to evaluate the effects of arginine, glutamine and fish oil given to 11 severe trauma patients, 10 burn patients and 5 cancer patients. Daily calories and proteins was based upon the patient's severity. The liquid immune formula was started at half concentration and administered through nasogastric tube by continuous drip at 30 ml/h, increasing to maximum level within 4 days. Additional energy and protein was administered by either parenteral or oral support. Nutritional, metabolic, immunologic and clinical parameters were measured at baseline (day 0), and at days 3, 7, and 14.

Results

Initial mean serum albumin and transferrin showed mile (trauma) to moderate (burn and cancer) degree of malnutrition. There was significant improvement of nutritional parameters at days 7 and 14 in the trauma and burn patients, and significant increase in total lymphocyte count (day 7), CD4+ count, (day 7), CD8+ count (day 7 and 14), complement C3 (day 7 and 14), IgG (day 7 and 14), IgA (day 7 and 14) in all patients. C-reactive protein decreased significantly on day 7 and 14. The feeding of the immune formula was well tolerated; significant improvement of nutritional and immunologic parameters was observed.

Conclusion

Further clinical trials using a prospective double-blind randomised design are required in order to clarified the benefit of using immunonutrition for critically ill patients.

References

Chuntrasakul C et al. Metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids supplementation in immunocompromised patients. J Med Assoc Thai 81(5): 334-43. May 1998.

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