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Comparison of a immunonutrition formula enriched arginine, glutamine and omega-3 fatty acid, with a currently high-enriched enteral nutrition for trauma patients.
J Med Assoc Thai. 2003 Jun; 86(6):552-61.JM

Abstract

The severe trauma or burn patients required aggressive resuscitation, operation and metabolic support to reduce morbidity and motality. Nutrition is one of the most important treatment for these patients, improving body protein and immune function, reducing rate of infection and shortening hospitalization.

METHOD

To evaluate the metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids (fish oil) supplementation, we performed a prospective study in patients age 15-60 yrs after severe trauma (Injury Severity Scores (ISS) 15-30) or burn patients (body surface area (BSA) 30-60%) in Siriraj Hospital. They were randomized to receive either Neomune or Traumacal. The nasogastric feeding was started in post-injury day 2 (PID2) with half of concentration at the rate of 30 ml/h. From PID3 to PID10, the normal concentration was administered at the rate of 80-100 ml/h depending on optimal caloric requirement. All patients received 5 per cent dextrose in half or full strength saline solution as clinically indicated. No other oral nutrients apart from study formula were allowed during the study. Blood sample was with-drawn on PID2, PID6 and PID11 for measurements of CBC, coagulogram, albumin, transferrin, CRP, LFT, BUN, Cr, CD3, CD19, CD4, CD8, C3, IgG, IgM, and IgA. Nitrogen balance was calculated from UUN. Unpaired student t-test was applied to compare variables between the two groups.

RESULTS

36 patients were selected (16 trauma and 20 burn), male = 29, mean age = 29.86 yrs. The patients were divided equally into two groups to receive Neomune or Traumacal. The data were compared and showed significance on total protein on PID11 (Neomune = 6.52 +/- 1.29, Traumacal = 5.59 +/- 1.21, p = 0.03) and serum triglycerides on PID11 (Neomune = 128.39 +/- 53.45, Traumacal = 186.25 +/- 84.07, p = 0.02). The ICU stay was observed shorter in Neomune than in Traumacal group (3.41 and 7.83 days) with no statistical significance. The wean-off respirator day was also shorter in Neomune than in Traumacal group (2.71 and 7.39 days). One patient in each group died.

CONCLUSIONS

The feeding of Neomune in critically injured patients was well tolerated as Traumacal and significant improvement was observed in serum protein. Shorten ICU stay and wean-off respirator day may benefit from using the immunonutrient formula.

Authors+Show Affiliations

Research Center for Nutrition Support, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12924804

Citation

Chuntrasakul, Chomchark, et al. "Comparison of a Immunonutrition Formula Enriched Arginine, Glutamine and Omega-3 Fatty Acid, With a Currently High-enriched Enteral Nutrition for Trauma Patients." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 86, no. 6, 2003, pp. 552-61.
Chuntrasakul C, Siltham S, Sarasombath S, et al. Comparison of a immunonutrition formula enriched arginine, glutamine and omega-3 fatty acid, with a currently high-enriched enteral nutrition for trauma patients. J Med Assoc Thai. 2003;86(6):552-61.
Chuntrasakul, C., Siltham, S., Sarasombath, S., Sittapairochana, C., Leowattana, W., Chockvivatanavanit, S., & Bunnak, A. (2003). Comparison of a immunonutrition formula enriched arginine, glutamine and omega-3 fatty acid, with a currently high-enriched enteral nutrition for trauma patients. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 86(6), 552-61.
Chuntrasakul C, et al. Comparison of a Immunonutrition Formula Enriched Arginine, Glutamine and Omega-3 Fatty Acid, With a Currently High-enriched Enteral Nutrition for Trauma Patients. J Med Assoc Thai. 2003;86(6):552-61. PubMed PMID: 12924804.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of a immunonutrition formula enriched arginine, glutamine and omega-3 fatty acid, with a currently high-enriched enteral nutrition for trauma patients. AU - Chuntrasakul,Chomchark, AU - Siltham,Soranit, AU - Sarasombath,Suttipant, AU - Sittapairochana,Chockchai, AU - Leowattana,Wattanas, AU - Chockvivatanavanit,Siriya, AU - Bunnak,Aroonrasamee, PY - 2003/8/20/pubmed PY - 2003/10/3/medline PY - 2003/8/20/entrez SP - 552 EP - 61 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 86 IS - 6 N2 - UNLABELLED: The severe trauma or burn patients required aggressive resuscitation, operation and metabolic support to reduce morbidity and motality. Nutrition is one of the most important treatment for these patients, improving body protein and immune function, reducing rate of infection and shortening hospitalization. METHOD: To evaluate the metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids (fish oil) supplementation, we performed a prospective study in patients age 15-60 yrs after severe trauma (Injury Severity Scores (ISS) 15-30) or burn patients (body surface area (BSA) 30-60%) in Siriraj Hospital. They were randomized to receive either Neomune or Traumacal. The nasogastric feeding was started in post-injury day 2 (PID2) with half of concentration at the rate of 30 ml/h. From PID3 to PID10, the normal concentration was administered at the rate of 80-100 ml/h depending on optimal caloric requirement. All patients received 5 per cent dextrose in half or full strength saline solution as clinically indicated. No other oral nutrients apart from study formula were allowed during the study. Blood sample was with-drawn on PID2, PID6 and PID11 for measurements of CBC, coagulogram, albumin, transferrin, CRP, LFT, BUN, Cr, CD3, CD19, CD4, CD8, C3, IgG, IgM, and IgA. Nitrogen balance was calculated from UUN. Unpaired student t-test was applied to compare variables between the two groups. RESULTS: 36 patients were selected (16 trauma and 20 burn), male = 29, mean age = 29.86 yrs. The patients were divided equally into two groups to receive Neomune or Traumacal. The data were compared and showed significance on total protein on PID11 (Neomune = 6.52 +/- 1.29, Traumacal = 5.59 +/- 1.21, p = 0.03) and serum triglycerides on PID11 (Neomune = 128.39 +/- 53.45, Traumacal = 186.25 +/- 84.07, p = 0.02). The ICU stay was observed shorter in Neomune than in Traumacal group (3.41 and 7.83 days) with no statistical significance. The wean-off respirator day was also shorter in Neomune than in Traumacal group (2.71 and 7.39 days). One patient in each group died. CONCLUSIONS: The feeding of Neomune in critically injured patients was well tolerated as Traumacal and significant improvement was observed in serum protein. Shorten ICU stay and wean-off respirator day may benefit from using the immunonutrient formula. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/12924804/Comparison_of_a_immunonutrition_formula_enriched_arginine_glutamine_and_omega_3_fatty_acid_with_a_currently_high_enriched_enteral_nutrition_for_trauma_patients_ L2 - https://medlineplus.gov/woundsandinjuries.html DB - PRIME DP - Unbound Medicine ER -