Nutrition
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of a glutamine-enriched enteral diet on intestinal permeability and infectious morbidity at 28 days in critically ill patients with systemic inflammatory response syndrome: a randomized, single-blind, prospective, multicenter study.
We investigated the effect of a glutamine-enriched enteral diet on intestinal permeability and infectious morbidity and mortality in critically ill patients who developed systemic inflammatory response syndrome after an acute event. Eleven intensive care units in tertiary-care hospitals participated in a prospective, randomized, single blind, multicenter trial. Eighty-four patients with systemic inflammatory response syndrome of any etiology were randomly allocated to receive a glutamine-enriched enteral diet or a control diet without glutamine. ⋯ There were no differences with respect to other infections, mortality, or length of stay. Intestinal permeability as assessed by the lactulose-mannitol test was unchanged in both groups. Glutamine-enriched enteral diets can decrease nosocomial infections in patients with systemic inflammatory response syndrome.
-
Randomized Controlled Trial Clinical Trial
Alpha-ketoglutarate-supplemented enteral nutrition: effects on postoperative nitrogen balance and muscle catabolism.
Enteral feeding in the early postoperative phase may improve gut integrity and reduce infectious complications after trauma and surgery. The aim of the current study was to evaluate the feasibility of alpha-ketoglutarate enrichment of enteral feeding and the effect on protein metabolism after major surgery. Patients undergoing elective abdominal surgery were randomly allocated to receive a standard whole-protein-based enteral nutrition solution (n = 9) or an isonitrogenous, isocaloric solution enriched with alpha-ketoglutarate (n = 11) for 5 d postoperatively. ⋯ Transthyretin decreased by 25% in both groups, and albumin decreased significantly in the enriched group compared with the standard nutrition. There were no significant differences in nitrogen balance, excretion of 3-methylhistidine, or clinical outcome between groups. Enrichment of a whole-protein-based formula with alpha-ketoglutarate did not improve protein metabolism or decrease muscle catabolism after major abdominal surgery.
-
Randomized Controlled Trial Clinical Trial
Infection, multiple organ failure, and survival in the intensive care unit: influence of glutamine-supplemented parenteral nutrition on acquired infection.
We investigated the effect of a glutamine-supplemented parenteral nutrition on intensive-care-acquired infection (ICAI) and its relation to outcome. ⋯ In these severely ill patients, parenteral nutrition containing glutamine may not reduce the overall incidence of ICAI, but it may reduce the risk of dying from acquired infections. The improved survival seen at 6 mo appeared related mostly to reduced mortality in the intensive care unit from multiple organ failure in those patients in whom acquired infections are common.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery.
Early enteral nutrition with fiber-containing solutions plus Lactobacillus may reduce bacterial translocation and minimize the incidence of infections after surgery. ⋯ Early enteral nutrition with fiber-containing solutions reduced the rate of postoperative infections in comparison with parenteral nutrition and fiber-free enteral formula. Addition of living Lactobacillus seemed to increase the benefits in patients with gastric and pancreatic resections.
-
Randomized Controlled Trial Clinical Trial
Circulating concentrations of soluble leptin receptor: influence of menstrual cycle and diet therapy.
Concentrations of the soluble leptin receptor (sOB-R) may be related to leptin resistance in obesity. We measured sOB-R concentrations in serum in 103 non-diabetic Japanese men and women. All subjects were grouped according to body mass index (BMI; in kg/m(2)). ⋯ Serum sOB-R concentrations did not change significantly during the menstrual cycle. Our results showed that serum sOB-R concentrations decrease with increasing BMI and that sex hormones likely do not affect serum sOB-R concentrations in non-pregnant women. The reduction in serum sOB-R concentrations in overweight and obese persons may reflect downregulation of hypothalamic leptin receptor production as a result of an increase in circulating leptin and might be an important factor in leptin resistance.