Immunonutrition and Cytokine Response in Patients with Head Injury
Jiraporn Khorana MD*, Kittipan Rerkasem MD, PhD*, Chatchawann Apichartpiyakul PhD**, Choompone Sakonwasun MD**, Wanarak Watcharasakslip MD*, Tanat Waniyapong MD*, Thanya Norasethtada MD*, Kaweesak Jittawatanarak MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ** Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Background : To investigate whether short-term postoperative immunonutrients feeding can modulate the
level of cytokines in patients with head injury compared to standard enteral tube feeding formula.
Material and Method: A randomized double-blind study was carried out on 40 moderate to severe head injury
patients. They were randomized to have continuous nasogastric tube feeding within 24 hours after surgery of
either the immunonutrient containing enteral formula (group A) or the standard enteral formula (group B).
The level of interleukin-6 (IL-6) and 10 (IL-10) were measured on day 1 (before feeding), and subsequently on
day 3 and day 5.
Results : Twenty patients were randomly selected in each group, who had similar severity levels of injury.
Compared to the level of IL-6 on day 1, the level of IL-6 was markedly reduced on day 3 in group A (p = 0.002),
whereas such reduction in group B was not statistically significant.
Conclusion : Short term postoperative immunonutrient feeding can reduce cytokine level, indicating that
systemic inflammatory response syndrome might be modulated by such feeding.
Keywords : Craniocerebral trauma, Cytokines, Enteral nutrition, Food, Formulated
