Immunological effects of parenteral nutrition on traumatized patients

ABSTRACT

Nutrition is one of the most important treatment for the traumatized patients, improving body protein and immune function, reducing rate of infection and shortening hospitalization. The aim of this work is to study the effect of early parenteral nutrition on the immunological and inflammatory variables. Thirty poly-traumatized patients with Injury Severity Score [ISS] 20-40 and within 6 hours after trauma were enrolled sequentially into a conventional [n = 15] and an parenleral [n = 15] groups. Conventional group was received intravenous regimen and hospital oral diet as soon as the bowel function returned. Parenteral nutrition plans were designed individually for the TPN group, based on their calculated caloric and protein requirement [25 k cal/kg] day. Laboratory investigations included blood sample for blood picture, serum total proteins, albumin, and C-reactive protein. Immunological parameters included interleukin 10 [IL-10], interleukin 6 [IL-6], immunoglobulins [IGA], CD4 and CD8 were determined by immunoassy kit. In the TPN group, the mean values of serum protein, 1st day was significantly increase [P < 0.01] versus 10th day, also the mean value of serum albumin was significantly increased on the 10th day. In relation to C-reactive protein CRP The mean values for conventional and TPN groups, on the 1st day showed significantly decrease versus 10th day in both groups. There were no significant changes as regard [IL-10] and [IL-6] all studied times in the conventional group. While in the TPN, [IL-10] showed significantly decrease at 10th day. Also IL-6 showed significantly decrease on 1st day and 10th day. Concerning immunoglobulins [IGA] In TPN group showed significantly increase in the 10th day. In the TPN group CD4 showed significantly increase between 1st day and 10th day. As regard CD8 in the TPN group show significantly decrease between 1st day and 10th day. In conclusion nutritional support of the traumatized patient is critically important to decrease the immunosuppression associated with injury