ABSTRACT
Objective To investigate the effects of enteral nutrition (EN) for diabetes mellitus on the clinical outcomes of critically ill patients with hyperglycemia.Methods Sixty-four critically il1 patients with hyperglycemia were randomly divided into the control group and intervention group.The control group was given homemade homogenized meals and the study group was given EN for diabetes mellitus.Both were given the same total energy and nitrogen content.EN was applied 3 days after ICU admission and then lasted 14 days.Blood glucose was controled at 6.1-8.5 mmol/L by insulin therapy.No albumin,blood plasma,or parenteral nutrition was provided to all patients.The lactulose mannitol ratio,biochemical indicators,total insulin dosage,and short-term and longterm outcomes were analyzed before and after EN support.The quality of life was evaluated using Stroke Specific Quality of Life Scale.Results Finally 59 patients were enrolled in the study,with 30 in the intervention group and 29 in the control group.The lactulose mannitol ratios in the intervenion group were significantly lower than those in the control group 7 days (0.221 ±0.117 vs.0.299 ±0.154,t =-2.199,P =0.032) and 14 days (0.169 ±0.122 vs.0.305 ±0.129,t =-4.191,P =0.000) after EN support.Meanwhile,the total insulin dosages were also significantly less in the intervention group [7 days,(195 ± 54) vs.(227 ± 60) U ; t =-2.096,P =0.041 ;14 days,(392 ±114) vs.(459 ±118) U; t =-2.221,P =0.030].Compared with the control group,the intervention group had significantly shorter duration of mechanical ventilation [(8.00 ± 1.75) d vs.(6.73 ±2.05) d,t=-2.547,P=0.014] and ICU stay[(10.00±1.95) vs.(8.80±2.17) d,t=-2.233,P=0.030],lower total hospitalization expenses [(56 238.39 ± 17 869.61) vs.(70 395.63 ±20 111.69) Yuan,t =-2.861,P =0.006],and faster recovery of daily activities [(17.59 ± 3.21) vs.(35.34 ± 8.65) scores,t =10.030,P =0.000] and living quality of life [(22.67 ± 4.51) vs.(40.55 ± 8.88) scores,t =9.397,P =0.000] after 90 days of treatment.Conclusion The EN for diabetes mellitus may improve the outcomes of critically ill patients with hyperglycemia compared with blend diet.
ABSTRACT
Objective:The purpose of the study was to investigate the effects of enteral nutrition on stress response and gut barrier function after surgery for esophageal cancer. Methods: Patients who underwent esophagectomy were divided into two groups. Group PN (28 patients) served as the control group. Group EN (26 patients) received enteral nutrition. Results: The serum total protein, albumin, prealbumin and transferrin decreased after operation, but there were no differences between the two groups. The serum levels of IL-6 were significantly higher on the first and third postoperative days after the operation in two groups (P
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Objectives:The purpose of this study was to investigate the effects of soybean oil emulsion on stress response and immune function after surgery for esophageal cancer. Mehtods:Patients who underwent esophagectomy with thoracotomy were divided into two groups.Group A(15 patients) received fatfree parenteral nutrition(PN) as the control group.Group B(18 patients) were fed by PN with soybean oil emulsion.There was no significant difference between the two groups in regard to either clinical backgrounds,nutritional parameters, or proteins measured before and after the operation. Results:The serum levels of cortisol and IL6 were significantly higher on the first and third postoperative days(P
ABSTRACT
Objective:The purpose of this randomized, controlled, clinical study was to investigate the effects of soybean oil emulsion on inflammatory response and immune function after surgery for esophageal cancer. Methods: Patients who underwent esophagectomy were divided into two groups. Group A( n = 15) ,the control group,received fat - free parenteral nutrition(PN). Group B( n = 18)re-ceived PN with soybean oil emulsion. There was no signficant difference between the two groups in regard to clinical backgrounds or non - protein calorie. Results: In both groups, the serum levels of IL - 6 were significantly higher on the first and third postoperative days. IL-6 levels in group B,however, were significantly higher than in group A. The serum concentration of IL- 10 showed a trend similar to that of IL-6.Serum IL-6 showed a significant positive correlation with IL- 10 on the 3rd day after the operation. The ratio of IL-6 to IL - 10 increased after the operation in both groups, and significant differences were observed between the two groups. CD4+ /CD8+ and NK cell activity significantly decreased postoperatively. Also, between group A and B there were statistically significant differences in CD4+ /CL8+ . Suppression of cellular immunity correlated significantly with serum IL- 6,and was preceded by a rise in serum IL- 6. Conclusion : Perioperative PN with excessive levels of soybean oil emulsion after a severely stressful operation has been shown to increase the production of inflammatory cytokines and promote immunosuppression.