Safety and intestinal tolerance of high-dose enteral antioxidants and glutamine peptides after upper gastrointestinal surgery.
OBJECTIVE
Safety and intestinal tolerance of an early high-dose enteral administration of antioxidative vitamins, trace elements, and glutamine dipeptides.


METHODS
open intervention trial.


METHODS
Two university teaching hospitals.


METHODS
A total of 14 patients requiring jejunal feeding (64+/-14 y).


METHODS
A measure of 500 ml/day Intestamin (FreseniusKabi: 250 kcal/1.050 kJ, 300 microg selenium, 20 mg zinc, 400 mug chromium, 1500 mg vitamin C, 500 mg vitamin E, 10 mg beta-carotene, 30 g glutamine) for 5 days beginning 6 h after surgery. Parenteral/enteral nutrition was provided to achieve energy target (25 kcal/kg/day).


METHODS
Intestinal complaints, plasma nutrients, and glutathione.


RESULTS
Only minor signs of nausea, hiccups, flatulence (3/14). Plasma micronutrients (except beta-carotene) postoperatively decreased and increased to normal on day 5. Extracellular glutamine remained low (preop: 520+/-94; d1: 357+/-67; d5: 389+/-79 micromol/l); total glutathione decreased (d1: 9.4+/-3.8; d5: 3.6+/-2.5 micromol/l).


CONCLUSIONS
Study feed is well tolerated and metabolically safe representing a valuable tool for targeted pharmaconutrient supply.
Schroeder
J
J
Universitätsklinik, Allgemeine Chirurgie und Thoraxchirurgie, Kiel, Germany.
Alteheld
B
B
Stehle
P
P
Cayeux
M-C
MC
Chioléro
R L
RL
Berger
M M
MM
D000975:Antioxidants / Q000008:administration & dosage* / Q000378:metabolism; D004750:Enteral Nutrition; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D005770:Gastrointestinal Neoplasms / Q000601:surgery / Q000628:therapy*; D005973:Glutamine / Q000008:administration & dosage* / Q000378:metabolism; D006801:Humans; D007408:Intestinal Absorption; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D012449:Safety; D013997:Time Factors; D014131:Trace Elements / Q000008:administration & dosage* / Q000378:metabolism; D016896:Treatment Outcome
D000975:Antioxidants; D014131:Trace Elements; D005973:Glutamine