0
ARTICLE |

Gut Function and Immune and Inflammatory Responses in Patients Perioperatively Fed With Supplemented Enteral Formulas

Marco Braga, MD; Luca Gianotti, MD, ScD; Andrea Cestari, MD; Andrea Vignali, MD; Fabio Pellegatta, MD; Alberto Dolci, MD; Valerio Di Carlo, MD
Arch Surg. 1996;131(12):1257-1265. doi:10.1001/archsurg.1996.01430240011001.
Text Size: A A A
Published online

Objective:  To evaluate if the perioperative administration of a supplemented enteral formula modulates selective inflammatory and immune variables and gut function after surgery.

Design:  Prospective, randomized, double-blind, clinical trial.

Setting:  Department of surgery, university hospital.

Patients:  Forty patients with neoplasm of the colorectum or stomach.

Intervention:  Seven days before surgery, the patients drank I L/d of a control enteral formula (n=20) or the same formula enriched with arginine, RNA, and ω-3 fatty acids (n=20). Jejunal infusion with the same formulas was started 6 hours after operation and continued until day 7.

Main Outcome Measures:  Immune response was determined by phagocytosis ability and respiratory burst of polymorphonuclear cells, and inflammatory response by plasma levels of C-reactive protein. Operative intestinal microperfusion, postoperative intestinal mucosa oxygen metabolism, and plasma intestinal isoenzyme of alkaline phosphatase were used as indicators of gut function. Plasma nitric oxide also was determined.

Results:  In the enriched group, phagocytosis ability and respiratory burst after surgery was higher (P<.01) and C-reactive protein level was lower (P<.05) than in the control group. The enriched group had higher mean (±SD) intestinal microperfusion (180±46 vs 146 ± 59 perfusion units, P<.05), intestinal mucosa oxygen metabolism (pHi 7.39±0.2 vs pHi 7.33±0.1, P<.05), and 5-fold lower levels of intestinal isoenzyme of alkaline phosphatase (P<.05). Postoperative levels of nitric oxide were higher in the enriched group (P<.05, analysis of variance).

Conclusion:  The perioperative administration of an enriched enteral formula significantly improved gut function and positively modulated postsurgical immunosuppressive and inflammatory responses.Arch Surg. 1996;131:1257-1265

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();