Effect of perioperative nutrition, with and without arginine supplementation, on nutritional status, immune function, postoperative morbidity, and survival in severely malnourished head and neck cancer patients

摘要: Background Malnourished head and neck cancer patients are at increased risk of postoperative complications. Objective We studied the effect perioperative, arginine-supplemented nutritional support on status, immune outcome, survival in severely malnourished (weight loss >10% body weight) undergoing major surgery. Design Forty-nine were randomly assigned to receive 1) no preoperative standard tube feeding, 2) or 3) feeding. Results Patients both prefed groups received approximately 9 d resulting energy intakes 110% 113% calculated needs (compared with 79% control group; P = 0.007). Compared enteral nutrition did not significantly improve status any biochemical immunologic indexes. Major complications occurred 53%, 47%, 59% study 1, 2, 3 (NS). A trend was seen toward better group (P 0.15). Secondary analysis showed that survivors had human leukocyte antigen-DR expression monocytes 0.05) higher endotoxin-induced cytokine production 0.010 for tumor necrosis factor alpha 0.042 interleukin 6) start than who died. Conclusions Nine days without arginine, reduce surgery-induced suppression, affect clinical outcome patients. supplemented arginine-enriched tended live longer. Some markers function may distinguish good bad prognoses.