title: Enteral n-3 fatty acids and micronutrients enhance percentage of positive neutrophil and lymphocyte adhesion molecules: a potential mediator of pressure ulcer healing in critically ill patients.
abstract: n-3 Fatty acids are recognised as influencing both wound healing and immunity. We assessed the impact of a fish oil- and micronutrient-enriched formula (study formula) on the healing of pressure ulcers and on immune function in critically ill patients in an intensive care unit. A total of forty patients with pressure ulcers and receiving nutritional support were enrolled (intervention group, n 20, received study formula; and a control group, n 20, received an isoenergetic formula). Total and differential leucocyte count and percentage of adhesion molecule positive granulocyte and lymphocyte cells (CD11a, CD11b, CD18 and CD49b) were measured on days 0, 7 and 14. Percentage of positive lymphocytes for CD54, CD49b, CD49d and CD8 were also measured on days 0, 7 and 14. The state of pressure ulcers was assessed by using the pressure ulcer scale for healing tool score on days 7, 14 and 28 of treatment. No between-group differences in patient demographics, anthropometry or diagnostic class were observed. Patients who received the study formula showed significant increases in the percentage of positive CD18 and CD11a lymphocytes and of CD49b granulocytes as compared to controls (P < 0·05). While the severity of pressure ulcers was not significantly different between the two groups on admission, severity increased significantly over time for the control group (P < 0·05), but not for the study group. The present study suggests that a fish oil- and micronutrient-enriched formula may prevent worsening of pressure ulcers and that this effect may be mediated by an effect on adhesion molecule expression.
authors: Department of General Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Campus Beilinson, Petah Tikva 49100, Israel.
authors: Miriam
authors: M
authors: Theilla
authors: Betty
authors: B
authors: Schwartz
authors: Yael
authors: Y
authors: Zimra
authors: Haim
authors: H
authors: Shapiro
authors: Ronit
authors: R
authors: Anbar
authors: Esther
authors: E
authors: Rabizadeh
authors: Jonathan
authors: J
authors: Cohen
authors: Pierre
authors: P
authors: Singer
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000378:metabolism; D016638:Critical Illness; D004750:Enteral Nutrition; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000378:metabolism; D018529:Nutritional Support; D003668:Pressure Ulcer / Q000097:blood / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D011446:Prospective Studies; D014945:Wound Healing
chemical_list: D015703:Antigens, CD; D015815:Cell Adhesion Molecules; D015525:Fatty Acids, Omega-3; D018977:Micronutrients