Metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids supplementation in immunocompromised patients.

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dc.contributor.authorChuntrasakul, Cen_US
dc.contributor.authorSiltharm, Sen_US
dc.contributor.authorSarasombath, Sen_US
dc.contributor.authorSittapairochana, Cen_US
dc.contributor.authorLeowattana, Wen_US
dc.contributor.authorChockvivatanavanit, Sen_US
dc.contributor.authorBunnak, Aen_US
dc.date.accessioned2009-05-27T21:09:31Z
dc.date.available2009-05-27T21:09:31Z
dc.date.issued1998-05-12en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractTo evaluate the nutritional, metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids (fish oil) supplementation in immunocompromised patients, we performed a prospective study on the effect of immune formula administered to 11 severe trauma patients (average ISS = 24), 10 burn patients (average % TBSA = 48) and 5 cancer patients. Daily calorie and protein administration were based on the patient's severity (Stress factor with the range of 35-50 kcal/kg/day and 1.5-2.5 g/kg/day, respectively) Starting with half concentration liquid immune formula through nasogastric tube by continuous drip at 30 ml/h and increasing to maximum level within 4 days. The additional energy and protein requirement will be given either by parenteral or oral nutritional support. Various nutritional, metabolic, immunologic and clinical parameters were observed on day 0 (baseline), day 3, 7, and 14. Analysis was performed by paired student-t test. Initial mean serum albumin and transferrin showed mild (trauma) to moderate (burn and cancer) degree of malnutrition. Significant improvement of nutritional parameters was seen at day 7 and 14 in trauma and burn patients. Significant increase of total lymphocyte count (day 7, P < 0.01), CD4 + count (day 7, p < 0.01), CD8 + count (day 7, p < 0.0005 & day 14, p < 0.05), complement C3 (day 7, p < 0.005 day 14, p < 0.01), IgG (day 7, and 14, p < 0.0005), IgA (day 7, p < 0.0005 & day 14, p < 0.05), in all patients. C-reactive protein decreased significantly on day 7 (p < 0.0005) and day 14 (p < 0.005). 3 cases of burn wound infection, one case of UTI and one case of sepsis were observed. Two cases of hyperglycemia in burn, 3 cases of hyperbilirubinemia in trauma, 10 cases of elevated LFT (5 trauma/5 burn), and one case of hyponatremia in cancer patients were observed. Two cases of nausea, 4 cases of vomiting, 5 cases of diarrhea (< 3 times/day), 2 cases of abdominal cramp, 1 case of distension were observed. The feeding of IMMUNE FORMULA was well tolerated and significant improvement was observed in nutritional and immunologic parameters as in other immunoenhancing diets. Further clinical trials of prospective double-blind randomized design are necessary to address the so that the necessity of using immunonutrition in critically ill patients will be clarified.en_US
dc.description.affiliationResearch Center for Nutritional Support, Siriraj Hospital.en_US
dc.identifier.citationChuntrasakul C, Siltharm S, Sarasombath S, Sittapairochana C, Leowattana W, Chockvivatanavanit S, Bunnak A. Metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids supplementation in immunocompromised patients. Journal of the Medical Association of Thailand. 1998 May; 81(5): 334-43en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/44297
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdulten_US
dc.subject.meshArginine --administration & dosageen_US
dc.subject.meshBurns --physiopathologyen_US
dc.subject.meshCD4-CD8 Ratioen_US
dc.subject.meshDietary Supplementsen_US
dc.subject.meshEnteral Nutritionen_US
dc.subject.meshFatty Acids, Omega-3 --administration & dosageen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlutamine --administration & dosageen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunocompromised Host --physiologyen_US
dc.subject.meshImmunoglobulins --blooden_US
dc.subject.meshLymphocyte Counten_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeoplasms --physiopathologyen_US
dc.subject.meshNutritional Statusen_US
dc.subject.meshPhenotypeen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshWounds and Injuries --physiopathologyen_US
dc.titleMetabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids supplementation in immunocompromised patients.en_US
dc.typeClinical Trialen_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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