Document Detail


Effects of early enteral nutrition on immune function of severe acute pancreatitis patients.
MedLine Citation:
PMID:  23431120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).
METHODS: Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN). Enteral nutrition was started within 48 h after admission in EEN group, whereas from the 8(th) day in DEN group. All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1, 3, 7 and 14 after admission. The clinical outcome variables were also recorded.
RESULTS: Sixty SAP patients were enrolled to this study. The CD4+ T-lymphocyte percentage, CD4+/CD8+ ratio, and the CRP levels in EEN group became significantly lower than in DEN group from the 7(th) day after admission. In contrast, the immunoglobulin G (IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7(th) day after admission. No difference of CD8+ T-lymphocyte percentage, IgM and IgA levels was found between the two groups. The incidences of multiple organ dysfunction syndrome, systemic inflammatory response syndrome, and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group. However, there was no difference of hospital mortality between the two groups.
CONCLUSION: EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression. EEN can improve the clinical outcome, but not decrease the hospital mortality of SAP patients.
Authors:
Jia-Kui Sun; Xin-Wei Mu; Wei-Qin Li; Zhi-Hui Tong; Jing Li; Shu-Yun Zheng
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  19     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-22     Completed Date:  2013-12-11     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  917-22     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT01507766
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Biological Markers / blood
C-Reactive Protein / metabolism
CD4-CD8 Ratio
Chi-Square Distribution
China
Enteral Nutrition / adverse effects,  methods*,  mortality
Female
HLA-DR Antigens / blood
Hospital Mortality
Humans
Immunocompetence
Immunocompromised Host
Immunoglobulin A / blood
Immunoglobulin G / blood
Inflammation Mediators / blood
Male
Middle Aged
Pancreatitis / blood,  diagnosis,  immunology,  mortality,  therapy*
Prospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/HLA-DR Antigens; 0/Immunoglobulin A; 0/Immunoglobulin G; 0/Inflammation Mediators; 9007-41-4/C-Reactive Protein
Comments/Corrections

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