Effect of Early Enteral Nutrition on the Immune Status of Patients in Intensive Care Unit: A Prospective Control Study_West China Medical Journal

Authors：

 WANGPan , WANGHong-yu , CAOYi-rui , ZHANGAn-ke , HUANGQiang

Intensive Care Unit, Wenjiang Branch of Sichuan Provincial People's Hospital/Wenjiang Districtial People's Hospital, Chengdu, Sichuan 611130, P. R. China;

Corresponding author：

Keywords：

Early enteral nutrition; Intensive care unit; Immunization; Prospective

DOI：

10.7507/1002-0179.20140385

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Objective To explore the effect of early enteral nutrition (EEN) on immune status of patients in intenseive care unit (ICU). Methods A prospective control study was conducted from July 2011 to December 2012, and 80 patients after trauma and surgery were admitted to ICU. The Patients were divided into EEN group and normal enteral nutrition (NEN) group randomly. Enteral nutrition in EEN group began within 24 hours after admitted to ICU, while within 48 hours in NEN group. Results In 80 patients, 78(37 in EEN group and 41 in NEN group) completed the end point. The baseline in two groups was consistent (P>0.05). The indicators of lymphocyte, IgA, IgG, IgM and CD4⁺, CD8⁺, natural kill cell and pre-albumin values in EEN group were higher than those in NEN group (P<0.05). The incidence of diarrhea (8.1%, 26.8%) and infection of wound (2.7%, 17.1%) in EEN were less than those in NEN group. The hospitalization duration in ICU in EEN group[(7.94±3.72) days] was also shorter than that in NEN group[(10.62±3.14) days]. Conclusion Early enteral nutrition improves immune function and nutrition status in ICU patients; it also protects gut barrier function and reduces the ICU hospitalization duration.

Citation： WANGPan, WANGHong-yu, CAOYi-rui, ZHANGAn-ke, HUANGQiang. Effect of Early Enteral Nutrition on the Immune Status of Patients in Intensive Care Unit: A Prospective Control Study. West China Medical Journal, 2014, 29(7): 1255-1258. doi: 10.7507/1002-0179.20140385 Copy

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13.	Gallagher-Allred CR, Voss AC, Finn SC, et al. Malnutrition and clinical outcomes:the case for medical nutrition therapy[J]. J Am Diet Assoc, 1996, 96(4):361-366, 369.
14.	Mechanick JI, Brett EM. Nutrition and the chronically critically ill patient[J]. Curr Opin Clin Nutr Metab Care, 2005, 8(1):33-39.
15.	葛可佑总. 中国营养科学全书[M]. 北京:人民卫生出版社, 2004:l739-1719.
16.	Eatock FC, Brombacher GD, Steven A, et al. Nasogastric feeding in severe acute pancreatitis may be practical and safe[J]. Int J Pancreatol, 2000, 28(1):23-29.
17.	Erstad BL. Enteral nutrition support in acute pancreatitis[J]. Ann Pharmacother, 2000, 34(4):514-521.
18.	Hiesmayr M. Nutrition risk assessment in the ICU[J]. Curr Opin Clin Nutr Metab Care, 2012, 15(2):174-180.
19.	Rothnie NG, Harper RA, Catchpole BN. Early postoperative gastrointestinal activity[J]. Lancet, 1963, 282(7298):64-67.
20.	顾葆春, 邢锐, 文强, 等. 危重病人早期肠内营养的临床应用分析[J]. 肠外与肠内营养, 2004, 11(1):20-22.
21.	Page CP, Ryan JA, Haff RC. Continual catheter administration of an elemental diet[J]. Surg Gynecol Obstet, 1976, 142(2):184-188.
22.	Awad WA, Ghareeb K, Paßlack N, et al. Dietary inulin alters the intestinal absorptive and barrier function of Piglet intestine after weaning[J]. Res Vet Sci, 2013, 95(1):249-254.
23.	Mcclave SA, Lowen CC, Snider HL. Immunonutrition and enteral hyperalimentation of critically ill patients[J]. Dig Dis Sci, 1992, 37(8):1153-1161.
24.	Cahill NE, Heyland DK. Bridging the guideline-practice gap in critical care nutrition:a review of guideline implementation studies[J]. JPEN J Parenter Enteral Nutr, 2010, 34(6):653-659.

1. Dobson K, Scott A. Review of ICU nutrition support practices:implementing the nurse-led enteral feeding algorithm[J]. Nurs Crit Care, 2007, 12(3):114-123.
2. 刘星, 王毅鑫, 苏文利. 改善严重创伤后免疫功能紊乱的研究进展[J]. 医学综述, 2008, 14(7):976-978.
3. Doig GS, Simpson F, Finfer S, et al. Effect of evidence-based feeding guidelines on mortality of critically ill adults:a cluster randomized controlled trial[J]. JAMA, 2008, 300(23):2731-2741.
4. 罗前颖. 重型颅脑损伤病人的早期肠内营养支持的进展[J]. 右江医学, 2007, 35(5):598-599.
5. 靳利英, 刘波. 肠内营养在重型颅脑损伤并发上消化道出血患者中的应用[J]. 中国实用医药, 2009, 4(5):70-71.
6. 周华, 杜斌, 柴文昭, 等. 我国危重症病人营养支持现状调查分析[J]. 肠外与肠内营养, 2009, 16(5):259-263, 268.
7. 黎介寿. 应激病人的代谢与营养支持[J]. 外科理论与实践, 2000, 5(2):70-72.
8. Jacka MJ, Zygun D. Survey of management of severe head injury in Canada[J]. Can J Neurol Sci, 2007, 34(3):307-312.
9. 昌震. ICU患者进行肠内营养支持治疗前后免疫功能的变化研究[J]. 现代预防医学, 2012, 39(23):6333-6335.
10. Heidegger CP, Darmon P, Pichard C. Enteral vs. parenteral nutrition for the critically ill patient:a combined support should be preferred[J]. Curr Opin Crit Care, 2008, 14(4):408-414.
11. Huynh D, Chapman MJ, Nguyen NQ. Nutrition support in the critically ill[J]. Curr Opin Gastroenterol, 2013, 29(2):208-215.
12. Sheean PM, Peterson SJ, Chen Y, et al. Utilizing multiple methods to classify malnutrition among elderly patients admitted to the medical and surgical intensive care units (ICU)[J]. Clin Nutr, 2013, 32(5):752-757.
13. Gallagher-Allred CR, Voss AC, Finn SC, et al. Malnutrition and clinical outcomes:the case for medical nutrition therapy[J]. J Am Diet Assoc, 1996, 96(4):361-366, 369.
14. Mechanick JI, Brett EM. Nutrition and the chronically critically ill patient[J]. Curr Opin Clin Nutr Metab Care, 2005, 8(1):33-39.
15. 葛可佑总. 中国营养科学全书[M]. 北京:人民卫生出版社, 2004:l739-1719.
16. Eatock FC, Brombacher GD, Steven A, et al. Nasogastric feeding in severe acute pancreatitis may be practical and safe[J]. Int J Pancreatol, 2000, 28(1):23-29.
17. Erstad BL. Enteral nutrition support in acute pancreatitis[J]. Ann Pharmacother, 2000, 34(4):514-521.
18. Hiesmayr M. Nutrition risk assessment in the ICU[J]. Curr Opin Clin Nutr Metab Care, 2012, 15(2):174-180.
19. Rothnie NG, Harper RA, Catchpole BN. Early postoperative gastrointestinal activity[J]. Lancet, 1963, 282(7298):64-67.
20. 顾葆春, 邢锐, 文强, 等. 危重病人早期肠内营养的临床应用分析[J]. 肠外与肠内营养, 2004, 11(1):20-22.
21. Page CP, Ryan JA, Haff RC. Continual catheter administration of an elemental diet[J]. Surg Gynecol Obstet, 1976, 142(2):184-188.
22. Awad WA, Ghareeb K, Paßlack N, et al. Dietary inulin alters the intestinal absorptive and barrier function of Piglet intestine after weaning[J]. Res Vet Sci, 2013, 95(1):249-254.
23. Mcclave SA, Lowen CC, Snider HL. Immunonutrition and enteral hyperalimentation of critically ill patients[J]. Dig Dis Sci, 1992, 37(8):1153-1161.
24. Cahill NE, Heyland DK. Bridging the guideline-practice gap in critical care nutrition:a review of guideline implementation studies[J]. JPEN J Parenter Enteral Nutr, 2010, 34(6):653-659.

West China Medical Journal

Effect of Early Enteral Nutrition on the Immune Status of Patients in Intensive Care Unit: A Prospective Control Study

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