Use of fibronectin and somatomedin-C as markers of enteral nutrition support in traumatized patients using a modified amino acid formula.
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.
Mattox
T W
TW
Departments of Clinical Pharmacy/Surgery, University of Tennessee, Memphis.
Brown
R O
RO
Boucher
B A
BA
Buonpane
E A
EA
Fabian
T C
TC
Luther
R W
RW
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*
D000597:Amino Acids, Branched-Chain; D005353:Fibronectins; D013002:Somatomedins