Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome
Daly JM, Lieberman MD, Goldfine J, Shou J, Weintraub F, Rosato EF, Lavin P
Surgery · 313 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- NIDDK NIH HHS
Según 1 financiador declarado.
Publicación
- Publicado
- 1992-07-01 · Surgery · vol. 112 · número 1 · págs. 56–67
- Editorial
- National Institutes of Health
- Citado
- 550 citas · más que el 100% de estudios similares · 30.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 0 trabajos
- Acceso
- De pago
- Áreas de investigación
- Clinical Nutrition and Gastroenterology · Enhanced Recovery After Surgery · Animal Nutrition and Physiology
- Palabras clave
- enteral nutrition, arginine supplementation, omega-3 fatty acids, postoperative nutrition, upper gastrointestinal cancer, immune function, lymphocyte mitogenesis, nitrogen balance, wound complications, infectious complications, length of hospital stay, elective surgery
- MeSH
- lymphocytes, humans, gastrointestinal neoplasms, nitrogen, fatty acids, omega-3, amino acids, arginine, rna, treatment outcome, enteral nutrition, life tables, regression analysis, cohort studies, lymphocyte activation, wound healing, energy intake, nutritional status, aged, middle aged, female, male
7 autores
- Jeanette M. Daly🇺🇸University of Pennsylvania
- M D Lieberman
- J Goldfine
- Jian Shou
- F Weintraub
- Ernest F. Rosato
- Philip T. Lavin
Resumen
El texto original del estudio, en el idioma en que se publicó.
The individual nutrients arginine, RNA, and omega-3 fatty acids improve immune function, but prospective trials have not demonstrated their effects on clinical outcome. Patients (n = 85) who underwent operation for upper gastrointestinal malignancies were randomized to receive the supplemental diet or a standard enteral diet after surgery. Clinical patient characteristics were similar between the two groups. Mean caloric intakes (1421 vs 1285 kcal/day) were similar between groups. Mean nitrogen intakes (15.6 vs 9.0 gm/day) and nitrogen balances (-2.2 vs -6.6 gm/day) measured in the first 20 patients were significantly greater in the supplemented group than in the standard group (p = 0.05). In vitro lymphocyte mitogenesis was measured in the first 31 patients and was decreased on postoperative day 1 in both groups, but normal levels were regained only in the supplemented group. In the cohort of 77 eligible patients, infectious and wound complications occurred significantly less often (11% vs 37%) in the supplemented group than in the standard group (p = 0.02). Linear logistic models for infectious/wound complications with control for the amount of nitrogen suggested (p = 0.10) dietary treatment as the major factor. Mean length of stay in the hospital was significantly shorter (p = 0.01) for the supplemented group (15.8 +/- 5.1 days) than for the standard group (20.2 +/- 9.4 days). These results suggest that postoperative enteral nutrition with supplemental arginine, 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.
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