title: Use of fibronectin and somatomedin-C as markers of enteral nutrition support in traumatized patients using a modified amino acid formula.
abstract: The purpose of this study was to evaluate the use of serum fibronectin and serum somatomedin-C as nutritional markers during enteral nutrition support (ENS) of critically ill, traumatized patients using an enteral product containing high concentrations of branched-chain amino acids. Twelve critically injured patients received a standard enteral formula with 30 g of a 44% branched-chain amino acid supplement added to each liter of formula. Fibronectin concentration, somatomedin-C concentration, and nitrogen balance were measured on study days 1, 4, 7, 14, 21, 28 or until adequate oral intake began. Both fibronectin and somatomedin-C concentrations increased significantly from baseline by day 7 of ENS. Nitrogen balance increased significantly from baseline by day 4. On days 14 and 21, only somatomedin-C and nitrogen balance increased significantly from baseline. Nitrogen balance was significantly correlated with somatomedin-C concentration (r = 0.53, p less than 0.01), cumulative caloric intake (r = 0.68, p less than 0.01), and cumulative nitrogen intake (r = 0.72, p less than 0.01). The results of this study suggest that serum somatomedin-C is useful and serum fibronectin has potential in monitoring nutrition support response in critically ill, traumatized patients.
authors.affiliation: Departments of Clinical Pharmacy/Surgery, University of Tennessee, Memphis.
authors.forename: T W
authors.initials: TW
authors.lastname: Mattox
authors.forename: R O
authors.initials: RO
authors.lastname: Brown
authors.forename: B A
authors.initials: BA
authors.lastname: Boucher
authors.forename: E A
authors.initials: EA
authors.lastname: Buonpane
authors.forename: T C
authors.initials: TC
authors.lastname: Fabian
authors.forename: R W
authors.initials: RW
authors.lastname: Luther
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D004750:Enteral Nutrition; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013002:Somatomedins / Q000032:analysis*; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D000597:Amino Acids, Branched-Chain; D005353:Fibronectins; D013002:Somatomedins