Comparison of Specialized and Standard Enteral Formulas in Trauma Patients

Rex O. Brown, Heather Hunt, Christine A. Mowatt‐Larssen, Stacey L. Wojtysiak, Mary F. Henningfield, Kenneth A. Kudsk

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Study Objective. To compare selected nutrition and immunologic markers and infection in trauma patients receiving a specialized enteral formula with those receiving standard enteral therapy. Design. Prospective, randomized clinical trial. Setting. Level 1 trauma center at a county government hospital. Patients. Forty‐one consecutive patients with major trauma who required enteral nutrition support. Thirty‐seven patients completed the study. Four patients (two in each group) were excluded, as additional operative procedures prevented initiation of enteral feedings within 7 days of injury. Interventions. Nineteen patients fed the specialized enteral formula received supplemental arginine, linolenic acid, β‐carotene, and hydrolyzed protein for up to 10 days. Eighteen control patients received standard enteral nutrition. Measurements and Main Results. After study entry, patients who received the specialized enteral formula had fewer infections than those receiving standard enteral nutrition (3/19 vs 10/18; p<0.05). The change in nitrogen balance was significantly better (p<0.05) from day 1 (−11.8 ± 1.8 g/day) to day 5 (−5.9 ± 2.0 g/day) for the group who received the specialized formula compared with the group who received standard enteral nutrition (‐7.3 ± 1.7 g/day to −7.4 ± 2.8 g/day). Similarly, the change in C‐reactive protein serum concentration was significantly better (p<0.05) from day 1 (18.0 ± 2.1 mg/dl) to day 5 (11.8 ± 1.5 mg/dl) in the group who received the specialized formula compared with the group who received standard enteral nutrition (17.6 ± 1.2 mg/dl to 14.4 ± 1.7 mg/dl). The CD4:CD8 ratio increased more in the group who received the specialized formula, although this difference did not reach statistical significance. Conclusion. Trauma patients who received the specialized enteral formula demonstrated a decreased incidence of infection and increased improvements in nitrogen balance and other indexes of stress. Additional clinical trials demonstrating positive patient outcomes are necessary before these specialized enteral formulas are used as the standard of practice in critically ill patients. 1994 Pharmacotherapy Publications Inc.

Original languageEnglish (US)
Pages (from-to)314-320
Number of pages7
JournalPharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume14
Issue number3
DOIs
StatePublished - Jan 1 1994

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Small Intestine
Enteral Nutrition
Wounds and Injuries
Nitrogen
Infection
County Hospitals
CD4-CD8 Ratio
Local Government
alpha-Linolenic Acid
Trauma Centers
Operative Surgical Procedures
Carotenoids
Critical Illness
Arginine
Publications
Blood Proteins
Randomized Controlled Trials
Biomarkers
Clinical Trials
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

Brown, R. O., Hunt, H., Mowatt‐Larssen, C. A., Wojtysiak, S. L., Henningfield, M. F., & Kudsk, K. A. (1994). Comparison of Specialized and Standard Enteral Formulas in Trauma Patients. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 14(3), 314-320. https://doi.org/10.1002/j.1875-9114.1994.tb02824.x

Comparison of Specialized and Standard Enteral Formulas in Trauma Patients. / Brown, Rex O.; Hunt, Heather; Mowatt‐Larssen, Christine A.; Wojtysiak, Stacey L.; Henningfield, Mary F.; Kudsk, Kenneth A.

In: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, Vol. 14, No. 3, 01.01.1994, p. 314-320.

Research output: Contribution to journalArticle

Brown, Rex O. ; Hunt, Heather ; Mowatt‐Larssen, Christine A. ; Wojtysiak, Stacey L. ; Henningfield, Mary F. ; Kudsk, Kenneth A. / Comparison of Specialized and Standard Enteral Formulas in Trauma Patients. In: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 1994 ; Vol. 14, No. 3. pp. 314-320.
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