Inflammatory Adverse Effects of Two Different Parenteral Nutrition Products Used in the Intensive Care Unit

Abstract

In the Intensive Care Unit (ICU) one of the most important routine treatment applications is nutritional support. In ICU parenteral nutritional products are prepared to provide for all the patient‘s needs. Insufficient nutrition may lead to insufficient inflammatory response. This study aimed to compare the inflammatory response of patients admitted to the ICU for different reasons fed soya oil-based and olive oil-based emulsions in terms of neutrophil lymphocyte rate (NLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), APACHE II score and SOFA scores. Our study retrospectively investigated the intensive care monitoring files and laboratory results of 25 patients with Glasgow Coma Scale 3-4. The patients given soya oil-based emulsion (Group S, n:14) and olive oil-based lipid emulsion (Group Z, n: 14) had NLR, CRP, ESR, APACHE II and SOFA scores recorded on the day they were admitted to ICU and on the 1st, 3rd, 5th and 10th day in ICU. The NLR in Group S was higher than the value in Group Z on the 5th day (p<0.05). The CRP value in Group Z was higher on the day of admittance compared to Group S (p<0.05). Comparing within Group S, the CRP value on the day of admittance was lower than the values on the other days (p<0.05). In Group S the ESR on the 5th day appeared to be higher than in Group Z (p<0.05). The APACHE II scores in Group S were higher than Group Z on the 1st, 3rd, 5th and 10th days (p<0.05). While olive oil-based lipid nutritional solutions appear to have more advantages in terms of immunoresponse compared to soya-based lipid nutritional solutions, taking note of the low number of patients in our study and the many factors not considered that may affect the situation, there is a need for prospective studies with carefully chosen patient groups and larger case numbers.

Keywords

• Intensive care unit, parenteral nutrition, inflammation

Yoğun Bakım Ünitesinde Kullanılan İki Farklı Paranteral Beslenme Ürününün İnflamatuar Yanıta Etkileri

Öz

Yoğun bakım ünitesinde (YBÜ) beslenme desteği en önemli rutin tedavi uygulamalarından biridir. YBÜ’de paranteral beslenme ürünleri hastaların bütün ihtiyaçlarını karşılayacak şekilde hazırlanmaktadır. Yetersiz beslenme yetersiz inflamatuar yanıta neden olabilir. Bu çalışmada, YBÜ ünitesine farklı nedenler ile yatırılan ve paranteral olarak soya yağı bazlı ve zeytinyağı bazlı emülsiyonlar ile beslenen hastaların inflamatuar yanıtının Nötrofil lenfosti oranı (NLO), C-Reaktif Protein (CRP), ESR (eritrosit sedimantasyon hızı), APACHE II skoru ve SOFA skorlarının karşılaştırılması amaçlanmıştır. Çalışmamızda Glaskow Koma Skalası 3-4 olan 25 hastanın, yoğun bakım takip dosyaları ve labartuvar sonuçları retospektif olarak incelendi. Soya yağı bazlı emülsiyon (GrupS, n:14) ve zeytinyağı bazlı lipid emülsiyon (GrupZ, n:14) kullanan hastaların YBÜ’e yatırıldığı gün, 1., 3., 5. ve 10. günlerdeki NLO, CRP, ESR, APACHE II ve SOFA skorlar kaydedildi. GrupS’nin NLO‘ı 5. günde Grup Z’ye göre yüksek bulundu (p< 0,05). Grup Z’nin CRP değeri geliş günü Grup S’ye göre yüksek bulundu (p

Anahtar Kelimeler

• Yoğun bakım ünitesi, parenteral beslenme, inflamasyon

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