Abstract
Both major surgery and other types of injury are associated with severe alterations of the host’s defense mechanisms and with an exuberant inflammatory response, making the patients highly susceptible to morbidity and mortality [1]. Nutritional support after injury may modulate immune, inflammatory and metabolic responses, gut function and clinical outcome of critically ill subjects. Early enteral versus parenteral feeding in traumatized and surgical patients is gaining wide consensus after promising results showing good tolerance and significant reduction of septic morbidity [2–6].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Meakins JL (1988) Host defense mechanisms in surgical patients: effect of surgery and trauma. Acta Chir Scand (suppl 550 ): 43–53
Moore FA, Feliciano DV, Andrassy RJ, et al (1992) Early enteral feeding, compared with parenteral, reduces postoperative septic complications. Ann Surg 216: 172–183
Kudsk KA, Croce MA, Fabian TC, et al (1992) Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating trauma. Ann Surg 215: 503–513
Hasse JM, Blue LS, Liepa G, et al (1995) Early enteral nutrition support in patients undergoing liver transplant. J Parent Enteral Nutr 19: 437–443
Braga M,Vignali A,Gianotti L,Cestari A, Profili M,Di Carlo V (1996) Immne and nutritional effects of early enteral nutrition after major abdominal operations. Eur J Surg 162: 105–112
Braga M,Vignali A, Gianotti L, Cestari A, Profili M, Di Carlo V (1995) Benefits of early postoperative enteral feeding in cancer patients. Infusionther Transfusionmed 22: 280–284
Barbour AG, Allred CO, Solberg SO, et al (1980) Chemiluminescence by polymorphonuclear leukocytes from patients with active bacterial infection. J Infect Dis 141: 14–26
Gianotti L, Alexander JW, Pyles T, Fukushima R (1993) Arginine-supplemented diets improve survival in gut-derived sepsis and peritonitis by modulating bacterial clearance: the role of nitric oxide. Ann Surg 217: 644–654
Gianotti L, Alexander JW, Gennari R, Pyles T (1995) Effect of oral glutamine on gut barrier function following thermal injury and immunosuppression. J Parent Enteral Nutr 19: 69–74
Gennari R, Alexander JW, Eaves-Pyles T (1995) Effect of different combinations of dietary additives on bacterial translocation and survival in gut-derived sepis. J Parent Enteral Nutr 19: 319–325
Braga M, Gianotti L, Costantini E, et al (1994) Impact of enteral nutrition on intestinal bacterial translocation and mortality in burned mice. Clin Nutr 13: 256–261
Gianotti L, Braga M, Vaiani R, Profili M, Socci C, Di Carlo V (1996) Effect of composition of enteral solutions and timing of administration on outcome and bacterial translocation. Riv Ital Nutr Parent Enteral 14: 191–195
Bone RC (1994) Sepsis and its complications: the clinical problem. Crit Care Med 22: S8–S11
Kinsella JE, Lokesh B, Broughton S, Whelan J (1990) Dietary polyunsaturated fatty acids and ei- cosanoids: potential effect on the modulation of inflammatory and immune cells: an overview. Nutrition 6: 24–44
Mascioli EA,Iwasa Y,Trimbo S,Leader L,Bristian BR,Blackburn GL (1989) Endotoxin challange after menhaden oil diet: effect on survival of guinea pigs. Am J Clin Nutr 49: 277–282
Wachtler P, Axel R, Kònig W, Bauer H, Kemen M, Kòller M (1995) Influence of a preoperative enteral supplementation on functional activities of peripheral leukocytes from patients with major surgery. Clin Nutr 14: 275–282
Kenler AS, Swails WS, Driscoll DF, et al (1996) Early feeding in postsurgical cancer patients. Fish oil structured lipid-based polymetric formula versus a standard polymetric formula. Ann Surg 223: 316–333
Raynold JV, Daly JM, Zhang S, et al (1988) Immunomodulatory mechanisms of arginine. Surgery 104: 141–151
Hall JC, Heel K, McCauley R (1996) Glutamine. Br J Surg 83: 305–312
Gianotti L, Alexander JW, Pyles T, et al (1996) Dietary fatty acids modulate host bactericidal response, microbial translocation and outcome following blood transfusion and thermal injury. Clin Nutr 15: 291–296
Gottschlich MM, Jenkins M, Warden GD, et al (1990) Differential effects of three dietary regimens on selected outcome variables in burn patients. J Parent Enteral Nutr 14: 225–236
Cerra FB, Lehmann S, Kostantinides N, et al (1991) Improvement in immune function in ICU patients by enteral nutrition supplemented with arginine, RNA and menhaden oil is indepen-dent of nitrogen balance. Nutrition 7: 193–199
Daly JM, Lieberman MD, Goldfine J, et al (1992) Enteral nutrition with supplemental arginine, RNA, and omega 3 fatty acids in patients after operation. Immunologic metabolic and clinical outcome. Surgery 112: 56–67
Vignali A, Braga M, Gianotti L, Cestari A, Profili M, Di Carlo V (1995) Impact of an enriched enteral formula on immune function and nutritional status in caner patients following surgery. Riv Ital Nutr Parent Enteral 13: 25–31
Kemen M, Senkal M, Homann HH, et al (1995) Early postoperative enteral nutrition with arginine-omega 3 fatty acids and ribonucleic acid-supplemented diet versus placebo in cancer patients: an immunologic evaluation of Impact®. Crit Care Med 23: 652–659
Senkal M, Kemen M, Homann HH, et al (1995) Modulation of postoperative immune response by enteral nutrition with a diet enriched with arginine, RNA, and omega-3 fatty acids in patients with upper gastrointestinal cancer. Eur J Surg 161: 115–122
Gianotti L, Braga M, Vignali A, et al (1997) Effect of route of delivery and formulation of postoperative nutritional support in patients undergoing major operations for malignant neoplasms. Arch Surg 132: 1222–1229
Senkal M, Mumme A, Eickhoff U, et al (1997) Early postoperative enteral nutrition: clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med 25: 1489–1496
Daly JM, Weintraub FN, Shou J, Rosato EF, Lucia M (1995) Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients. Ann Surg 221: 327–338
Wigmore SJ, Fearon KCH, Ross JA (1997) Modulation of human hepatocyte acute phase protein production by n-3 and n-6 polyunsaturated fatty acids. Ann Surg 225: 103–111
Daly JM, Reynolds J, Thom A (1988) Immune and metabolical effect of arginine in surgical patients. Ann Surg 208: 512–523
Moore FA, Moore EE, Kudsk KA, et al (1994) Clinical benefits of an immune-enhancing diet for early postinjury enteral feeding. J Trauma 37: 607–615
Bower RH, Cerra FB, Bershadsky B, et al (1995) Early enteral administration of a formula (Impact®) supplemented with arginine, nucleotides and fish oil in intensive care unit patients: Results of a multicenter, prospective, randomized clinical trial. Crit Care Med 23: 436–449
Kudsk KA, Minard G, Croce MA, et al (1996) A randomized trial of isonitrogenous enteral diets after severe trauma. An immuno-enhancing diet reduces septic complications. Ann Surg 224: 531–543
Braga M, Gianotti L, Vignali A, et al (1998) Artificial nutrition after abdominal surgery: Impact of route of administration and composition of the diet. Crit Care Med (in press)
Braga M, Gianotti L, Cestari A, et al (1996) Gut function, immune and inflammatory responses in patients perioperatively fed with supplemented formulas. Arch Surg 131: 1257–1265
Saito H, Trocki O, Wang SL, et al (1987) Metabolic and immune effects of dietary arginine supplementation after burn. Arch Surg 122: 784–789
Fukushima R, Gianotti L, Alexander JW, Pyles T (1992) The degree of bacterial translocation is a determinant factor for mortality after burn injury and is improved by prostaglandin analogs. Ann Surg 216: 438–445
Fukushima R, Alexander JW, Gianotti L, Pyles T, Ogle CK (1995) Bacterial translocation-related mortality may be associated with neutrophil-mediated organ damage. Shock 3: 323–328
Gianotti L, Nelson JW, Alexander JW, et al (1994) Postinjury hypermetabolic response and magnitude of bacterial translocation. Prevention by early enteral nutrition. Nutrition 10: 225–231
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Braga, M., Gianotti, L., Vignali, A. (1998). Immunonutrition in Cancer Surgical Patients. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1998. Yearbook of Intensive Care and Emergency Medicine, vol 1998. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72038-3_54
Download citation
DOI: https://doi.org/10.1007/978-3-642-72038-3_54
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-63798-1
Online ISBN: 978-3-642-72038-3
eBook Packages: Springer Book Archive