title: Effects of Delayed Enteral Nutrition on Inflammatory Responses and Immune Function Competence in Critically Ill Patients with Prolonged Fasting.
abstract: Although different studies suggest that early enteral nutrition (EEN) has benefits in reducing infectious complications, there is no data that addresses whether delayed enteral nutrition (EN) is detrimental and if it may have effects on inflammatory responses and immune function. Forty-five critically ill patients with long fasting were randomly allocated in two groups according to the type of nutritional support. The first group included patients assuming a standard enteral nutrition (EN, n = 22) and the second group assuming a parenteral nutrition (PN, n = 23). The daily nutritional amount was 25 kcal (105 kJ)/kg for all patients. The inflammatory markers white blood cells (WBC), C-reactive protein (CRP), TNF-α, IL-1-β, IL-6, IL-4, IL- 10 and the immune T-lymphocyte sub-populations CD3+, CD4+, CD8+, and HLA-DR+ were evaluated at day 1, and after 2, 3 and 7 days. IL-4, IL-10, CD3+, CD4+, CD8+ and the CD4+/CD8+ ratio were not statistically different between the two groups. WBC and TNF-α in EN patients were higher than those in PN after 3 and 7 days (P < 0.05). CRP and IL-6 levels were higher in EN patients than those assuming a PN after 2 and 3 days (P < 0.05). HLA-DR levels in patients assuming an EN were found higher than those in PN at day 7 (P < 0.05). Delayed EN for critically ill patients with long-term fasting increased systemic inflammatory responses, whereas EN could modify immune function, therefore reducing hospital stay and costs.
authors.forename: Fengchan
authors.initials: F
authors.lastname: Xi
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Geng
authors.forename: Tao
authors.initials: T
authors.lastname: Gao
authors.forename: Juanjuan
authors.initials: J
authors.lastname: Zhang
authors.forename: Tanshan
authors.initials: T
authors.lastname: Jun
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Lin
authors.forename: Weiqin
authors.initials: W
authors.lastname: Li
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.forename: Wenkui
authors.initials: W
authors.lastname: Yu
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016516:CD4-CD8 Ratio; D002681:China; D016638:Critical Illness; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005215:Fasting; D005260:Female; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000009:adverse effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators