Metabolic and Immune Effects of Dietary Arginine, Glutamine and Omega-3 Fatty Acids Supplementation in Immunocompromised Patients
CHOMCHARK CHUNTRASAKUL, M.D., F.A.C.S.*, SUTTIP ANT SARASOMBATH, M.D.**, WATT ANA LEOWATTANA, M.D.***, AROONRASAMEE BUNNAK, R.N., M.S.* SORANIT SILTHARM, M.D.*, CHOCKCHAI SITTAPAIROCHANA, M.D.***, SIRIYA CHOCKVIVATANAVANIT, R.N.*,
Affiliation : * Research Center for Nutritional Support, Siriraj Hospital, ** Department of Immunology, Faculty of Medicine, Siriraj Hospital, *** Department of Clinical Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700. Thailand.
Abstract
To evaluate the nutritional, metabolic and immune effects of dietary arginine, glutamine
and omega-3 fatty acids (fish oil) supplementation in immunocompromised patients, we per-
formed a prospective study on the effect of immune formula administered to II severe trauma
patients (average ISS = 24), 10 burn patients (average % TBSA = 48) and 5 cancer patients. Daily
calorie and protein administration were based on the patient's severity (Stress factor with the
range of 35-50 kcal/kg/day and 1.5-2.5 g/kg/day, respectively) Starting with half concentration
liquid immune formula through nasogastric tube by continuous drip at 30 ml/h and increasing
to maximum level within 4 days. The additional energy and protein requirement will be given
either by parenteral or oral nutritional support. Various nutritional, metabolic, immunologic and
clinical parameters were observed on day 0 (baseline), day 3, 7, and 14. Analysis was performed
by paired student-t test. Initial mean serum albumin and transferrin showed mild (trauma) to
moderate (burn and cancer) degree of malnutrition. Significant improvement of nutritional
parameters was seen at day 7 and 14 in trauma and burn patients. Significant increase of total
lymphocyte count (day 7, P Keywords :
