Effects of perioperative enteral immunonutrition on nutritional status, immunity and inflammatory response of elderly patients

Abstract

To evaluate the effects of perioperative enteral immunonutrition on the nutritional status, immunity, and inflammatory response of the elderly patients. Eighty malnourished patients aged over 60 with malignant gastrointestinal tumors undergoing radical surgery were randomly divided into 2 groups: experimental group (immunonutrition group, n = 37), and control group (n = 43). In the experimental group Supportan and glutamine, with the calorific value of 125.4 kJ.kg(-1).d(-1), were given orally or by nasointestinal tube for 5 days before operation, through jejunostomy or nasointestinal tube during operation, and then through nasointestinal tube since the day 2 to day 9 after post-operationally. In the control group Nutrition with the same amount of calorific value was given in the same manner as mentioned above. Peripheral blood samples were collected 5 and 1 days pre-operationally, and 1 and 9 days post-operatively to examine the serum albumin (ALB), prealbumin (PA), transferrin (TFN), CD3, CD4, CD8, CD4/CD8, immunoglobulin (Ig) G, IgA, IgM, and C-reactive protein (CRP). Nine days after operation, the serum TFN was 2.18 g/L +/- 0.29 g/L, PA was 0.23 g/L +/- 0.09 g/L, CD4 was 33.8% +/- 5.4%, CD4/CD8 was 1.17 +/- 0.12, and IgG was 13.2 g/L +/- 1.8 g/L. all significantly higher than those of the control group (1.95 g/L +/- 0.28 g/L, 0.19 g/L +/- 0.03 g/L, 31.1% +/- 5.2%, 1.05 +/- 0.10, and 12.11 g/L +/- 1.53 g/L respectively, all P < 0.05). Perioperative enteral immunonutrition improves the nutritional status and immune function, und reduces the acute inflammatory response of elderly patients.