The effect of parenteral nutrition products on infection parameters in patients receiving long-term mechanical ventilation support

Year 2023, Volume: 6 Issue: 2, 257 - 262, 27.03.2023

Öztürk Taşkın , Ufuk Demir

https://doi.org/10.32322/jhsm.1216642

Abstract

Aim: Malnutrition can increase the frequency of infections by reducing the immune system response. Parenteral nutrition (PN) is considered an important treatment for patients who cannot receive adequate oral or enteral nutrition. The contents of nutritional products may be different. In this study, we aimed to investigate the effects of soy-based and olive oil-based parenteral nutrition products on infection parameters.
Material and Method: A total of 82 patients were included in the study, 50 of which were soy (Group 2) and 32 were olive-based (Group 1) parenteral nutrition. Patient files and laboratory results were reviewed. Age, gender, 1st, 7th, 14th and 21st days in intensive care, leukocyte and platelet counts, Neutrophil lymphocyte ratio (NLR), C-Reactive Protein (CRP) values, Acute Physiology and Chronic Health Evaluation (Apache II) score and first blood culture results after hospitalization were recorded.
Results: The 7th and 21st day CRP values in Group 1 were statistically significantly lower than the 7th and 21st days CRP values in Group 2. In Group 1, growth in blood culture was statistically significantly lower and in Group 2 there was a statistically significant early growth.
Conclusion: As a result, it was found that olive oil-based lipid-containing nutritional solutions were more advantageous in terms of infection on intensıve care than soy-based nutrition products. It was concluded that patients who received postoperative mechanical ventilator support fed with olive oil-based parenteral nutrition products had less infectious growth.

Keywords

inflammation, immunity, critical care, parenteral nutrition

References

• Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003; 22: 235-9.
• Giner M, Laviano A, Meguid MM, Gleason JR. In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists. Nutrition 1996; 12: 23-9.
• Singer P, Berger MM, Van den Berghe G, et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr 2009; 28: 387-400.
• Fernández Ortega EJ, Ordóñez González FJ, Blesa Malpica AL. Soporte nutricional del paciente crítico: a quién, cómo y cuándo? [Nutritional support in the critically ill patient: to whom, how, and when?]. Nutr Hosp 2005; 20: 9-12.
• Demirkıran O. ESPEN Parenteral Nütrisyon Rehberleri: Yoğun Bakım. Kutlay O,Gündoğdu H (editörler). ESPEN Parenteral Nütrisyon Rehberi. 1. Baskı 2011: 38-52
• Esen F. İmmünonütrisyon. ANKEM Derg 2001; 15: 564-6.
• Mateu-de Antonio J, Grau S, Luque S, Marín-Casino M, Albert I, Ribes E. Comparative effects of olive oil-based and soyabean oil-based emulsions on infection rate and leucocyte count in critically ill patients receiving parenteral nutrition. Br J Nutr 2008; 99: 846-54
• Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009; 41: 1149-60.
• Petrozza PH, Prough DS: Postoperative and Intensive Care. Cottrell JE, Smith DS (eds).4th ed St Louis, Mosby: Anesthesia and Neurosurgery 2001: 623-61.
• Gürsoy N, Kaymak Ç, Özcan A, et al. Parenteral beslenen yoğun bakım hastalarında soya yağı, zeytinyağı ve Mct-Lct bazlı nutrisyon solüsyonlarının etkilerinin karşılaştırılması. J Turk Soc Intens Care 2012; 10: 52-8
• Wang H, Ye J. Regulation of energy balance by inflammation: common theme in physiology and pathology. Rev Endocr Metab Disord 2015; 16: 47-54.
• Lee JH, Waller JC, Melton SL, Saxton AM, Pordesimo LO. Feeding encapsulated ground full-fat soybeans to increase polyunsaturated fat concentrations and effects on flavor volatiles in fresh lamb. J Anim Sci 2004; 82: 2734-41.
• Cury-Boaventura MF, Gorjão R, de Lima TM, et al.Toxicity of a soybean oil emulsion on human lymphocytes and neutrophils. JPEN. J Parenter Enter Nutr 2006; 30: 115–23.
• Macri EV, Lifshitz F, Alsina E, et al. Monounsaturated fatty acids-rich diets in hypercholesterolemic-growing rats. Int J Food Sci Nutr 2015; 66: 400-8.
• Wanten G. An update on parenteral lipids and immune function: only smoke, or is there any fire? Curr Opin Clin Nutr Metab Care 2006; 9: 79-83.
• Ockenga J, Borchert K, Rifai K, Manns MP, Bischoff SC. Effect of glutamine-enriched total parenteral nutrition in patients with acute pancreatitis. Clin Nutr 2002; 21: 409-16.
• Singh D, Saxena S, Bogra JS, Chaudhary AK, Chandra G, Bhushan S. A comparative study of the effect of parentral and oral glutamine on biochemical parameters and on the duration of ICU stay in critically ill patients. Anaesth Pain Intensive Care 2019; 17: 123-7.
• Zhang L, Li F, Bai Y, Liu K, Liu M. Effects of glutamine on inflammatory cascade, serum high mobility group protein 1 and heat shock protein in patients with severe pancreatitis. Acta Medica Mediterranea 2020; 36: 281- 5.