Effects of malnutrition on the acute phase response of plasma proteins in patients undergoing total gastrectomy

Dominioni, Lorenzo; Dionigi, Renzo; Jemos, V.; Bonomi, E; d’Eril, G.V. Melzi; Ri, Paolo Dal

doi:10.1016/0261-5614(83)90008-0

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…A study investigating malnourished cancer patients, defined by a plasma albumin level of Ͼ 32 g/L, compared postoperative APP to control patients undergoing moderate elective surgery. Some proteins, such as ␣ 1 -acid glycoprotein, circulated in lower concentrations, whereas others such as C-reaction protein (CRP) appeared at increased levels postoperatively in depleted patients [24]. A more recent report using a more solid anthropometric definition for depletion, found a decreased response of CRP after surgery but no changes in other measured APPs, such as ␣ 1 -acid glycoprotein or albumin in the depleted groups [25].…”

Section: Effects Of Nutritional Depletion On the Immune Systemmentioning

confidence: 99%

Nutritional Depletion and Dietary Manipulation: Effects on the Immune Response

et al. 1999

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The association between nutritional depletion and the increased susceptibility for infectious diseases has been recognized for a long time. The complexity of the immune system, however, makes it difficult to unravel the underlying mechanisms. It appears that depletion adversely affects virtually all components of the immune system. This review provides an overview over the specific requirements of substrates by immune cells and the effects of nutritional depletion on various components of the immune response, with special attention to gut-associated lymphoid tissue. The literature concerning effects of dietary interventions with specific nutrients on the immune response is also discussed. Finally, we offer a hypothesis with regard to the improvement of composition of "trauma" nutrition solutions.

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Section: Effects Of Nutritional Depletion On the Immune Systemmentioning

confidence: 99%

Nutritional Depletion and Dietary Manipulation: Effects on the Immune Response

et al. 1999

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“…Such a possibility must always be taken into account especially in surgical or septic patients. Under these circumstances, sequential determinations should be scheduled in order to study the overall acute-phase response, which has been shown to correlate with undernutrition [4]. About 30 acute-phase proteins (APP) have been identified either in humans or in experimental animals.…”

Section: Definition Of Type and Degree Of Malnutritionmentioning

confidence: 99%

Nutritional assessment and severity of illness classification systems: A critical review on their clinical relevance

et al. 1986

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Several studies have attempted to define nutritional parameters that can be used to select undernourished hospitalized patients and identify those who present higher risk of postoperative septic complications. Nevertheless, the majority of these studies do not take into consideration the severity of infectious episodes. Systems for scoring the severity of illness are of critical importance in hospital practice and clinical research. In fact, they could be used for the following purposes: (a) a more correct stratification of patients in clinical studies; (b) monitoring the evolution of the infectious complication; (c) prediction of survival; (d) optimization of the criteria for admission to and discharge from intensive care units; and (e) evaluation of quality, quantity, and costs of nutritional therapy in critically ill patients. In this article, the authors present a critical review on the clinical relevance of the methods of nutritional assessment more commonly used in clinical practice; and, moreover they discuss the more recently proposed systems for scoring the severity of illness.

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“…These data suggest that short-term portal nutrition is feasible and safe, with metabolic effects that are at least similar to and possibly better than those of systemic nutrition. (Journal of Parenteral Nutrition 17: [20][21][22][23][24]1993) It is commonly accepted that intravenous nutrition does not support optimally the nitrogen utilization~ and protein hepatic synthesis,' because the infused substrates are first delivered into systemic circulation and peripheral tissues, where high insulin levels lead to the preferential uptake of nutrients into muscle and adipose stores.3-5 In these conditions, the liver seems to lose its key role in modulation of the nutrient profiles that will be additionally available to the peripheral tissues and only gets the rate of substrates that is proportional to the flux in the hepatic artery (approximately 8% of the total cardiac output). On the other hand, a substantial body of data indicates that during sepsis or trauma (conditions that frequently require nutrition support) there is muscle proteolysis and a decrease in amino acid uptake in skeletal muscle that yields a nitrogen translocation from the periphery to the liver to be finalized for a better protein synthesis and finally for host survival.…”

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confidence: 99%

Does Portal Nutrition Benefit Liver Protein Synthesis?

Bozzetti

Regalia

Barbieri

et al. 1993

J Parenter Enteral Nutr

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There are only a few experimental investigations on the feasibility and potential advantages of intraportal nutrition in animals and only two uncontrolled studies in humans. The purpose of this study was to compare some metabolic variables in patients who received portal or systemic nutrition after elective surgery for colorectal cancer. Twenty patients were randomized to receive postoperatively for a week a hypocaloric, "protein sparing" standard infusion via the portal (catheter in the gastroepiploic vein) (10 patients) or systemic (10 patients) route. We evaluated the basal concentrations of some visceral and acute-phase proteins and their variations in the first postoperative week and the nitrogen balance. Statistical analysis was performed by the two-tailed Student t test. There was no difference in the daily changes of the visceral and acute-phase proteins after surgery in the two groups of patients, but in the portal group there was a significantly better recovery of the level of total protein, albumin, and cholinesterase at the end of the portal infusion vs the systemic group (p < or = .005, .03, and .02, respectively). In regard to the nitrogen balance, although there was no difference in the overall balance between portal and systemic nutrition, if we separate the acute phase of the injury from the later one we do not see any significant difference in the first period but we do see a highly significant advantage for the portal group during the last 2 days (p < or = .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

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Effects of malnutrition on the acute phase response of plasma proteins in patients undergoing total gastrectomy

Cited by 8 publications

References 15 publications

Nutritional Depletion and Dietary Manipulation: Effects on the Immune Response

Nutritional Depletion and Dietary Manipulation: Effects on the Immune Response

Nutritional assessment and severity of illness classification systems: A critical review on their clinical relevance

Does Portal Nutrition Benefit Liver Protein Synthesis?

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