[An experimental study on the effects of postburn dietary supplementation of enhanced nutrients] [Chinese]

Department of Burns, Ruijin Hospital, The Second Shanghai Medical University, PR China.
Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns 08/2003; 19(4):197-201.
Source: PubMed


To evaluate the effects of postburn dietary supplementation of arginine (Arg), omega-3 polyunsaturated fatty acid (omega-3PUFA) and glutamine (Glu) on the metabolism, immunology and wound healing in scalded rats.
Thirty Sprague-Dawley (SD) rats inflicted with 30% total body surface area deep partial thickness scald on the back after the gastrostomy catheter was placed were employed as the model. The rats were randomly divided into A and B groups, and all of them received continuous isonitrogenous (25% protein, 12% fat, 63% carbohydrate), isocaloric (175 kcal/kg/day), and isovolemic intragastric tube feedings. The contents of Arg, omega-3PUFA, Glu in the dietary of B group were enriched. The parameters were measured on the 10th day after injury, including the response of spleen cells to ConA, the plasma levels of PGE(2), IL-2, albumin, transferrin, glucagons, cortisol in blood, the urinary content of vanillylmandelic acid (VAM) in 24-hour urine, the content of hydroxyproline, the ratio of type I to type III collagen in burn wounds, and the nitrogen content in the liver and in the jejunal mucosa, as well as the weight changes, skin delayed hypersensitivity test, and wound healing time.
It was revealed that the serum level of albumin, the nitrogen content in the liver and in the jejunal mucosa were obviously higher in B than those in A group. At the same time, there was no statistical difference in the plasma levels of cortisol and glucagons and urinary content of VAM between the two groups, nor in body weight changes. Meanwhile, the response of spleen cells to ConA and the skin delayed hypersensitivity induced by DNFB 14 days after injury in group B were also enhanced compared with those in group A. Although the expression of PGE2 from peritoneal macrophages was lower, the content of hydroxyproline from burn wounds in group B was significantly higher than that in group A, and the ratio of type l to type III collagen in group B was significantly lower than that in group A. Compared with group A, the wound healing time in group B was significantly shortened (P < 0.05).
The low-fat and high-protein feeding diet with enriched arginine, omega-3 PUFA, glutamine could benefit the nutritional status after burn injury, thus improve the immunological function and promote wound healing.

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    ABSTRACT: With burn injuries involving a large total body surface area, damage and breakdown of tissues can result in a condition similar to that seen with severe malnourishment. In addition, destruction of the effective skin barrier leads to body temperature dysregulation and increased susceptibility to infection and fluid loss. Previous studies have investigated specific naturally occurring additives to nutritional support, which may lead to an increase in immune system function and therefore a reduction in infection, hospital length of stay and chance of death. These additives are termed immunonutrients and include glutamine, arginine, branched-chain amino acids (BCAAs) and omega-3 fatty acids (fish oil). The authors of this review searched for randomised controlled trials assessing the effects of immunonutrients in patients with severe burn injury. Results of this review show that only glutamine could potentially reduce risk of death. However, the total number of patients within the combined studies is too small; therefore conclusions may be imprecise. More studies are needed to determine the efficacy of immunonutrition.
    Cochrane database of systematic reviews (Online) 12/2014; 12:CD007174. DOI:10.1002/14651858.CD007174.pub2 · 6.03 Impact Factor

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