Effect of immune-enhancing diets on the outcomes of patients after major burns.
The use of immune-enhancing diets (IEDs) has been shown to be beneficial in some categories of critically ill patients. This study aimed to evaluate the effect of early enteral feeding supplemented with glutamine and omega-3 fatty acids, as immune-enhancing diets, on the outcomes of patients after major burns. Forty thermally injured adult patients with 30-50% total body surface area (TBSA) burns, including deep areas ranging from 5-20%, were randomized into a prospective, double-blind, controlled clinical trial. They were placed into two equal groups: group A (IED group), in which patients received early enteral feeding supplemented with glutamine and omega-3 fatty acids as immune-enhancing diets; and group B (control group), in which patients received early enteral feeding not supplemented with immune-enhancing diets. Laboratory assessment of serum albumin, serum C-reactive protein, total lymphocytic count and serum immunoglobulins (IgA, IgG and IgM) was performed at admission, and on days 4, 7 and 14. Finally, outcomes were assessed by monitoring the survival rate, the length of hospital stay and the incidence of infection. There were no significant differences between the IED and control group regarding age (28.7±5.32 versus 29.85±5.94), sex, weight, %TBSA (37.75±4.4 versus 38.3±4.84) and %burn depth (11.7±2.36 versus 10.7±2.036). The incidence of infection (2 versus 8) and the length of hospital stay (16.3±0.92 days versus 17.95±2.96 days) were decreased significantly in the IED group versus the control group. There was no significant difference between the survival rates in both groups as there was only one death in the control group. Thanks to IEDs, patient outcome was improved and infectious morbidity and length of hospital stay were reduced, but there was no effect on the survival rates following major burns.
Plastic, Reconstructive and Burns Unit, Tanta Faculty of Medicine, Tanta, Egypt.
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Mahmoud
Plastic, Reconstructive and Burns Unit, Tanta Faculty of Medicine, Tanta, Egypt.
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Mostafa
Plastic, Reconstructive and Burns Unit, Tanta Faculty of Medicine, Tanta, Egypt.
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Abdel-Khalek
Plastic, Reconstructive and Burns Unit, Tanta Faculty of Medicine, Tanta, Egypt.
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Shalaby
glutamine; immune-enhancing diets (IEDs); major burns; omega-3 fatty acids; survival