Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma

K. A. Kudsk, G. Minard, S. L. Wojtysiak, Martin Croce, Timothy Fabian, Rex Brown

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Background. Sepsis and the route of nutrient administration are clearly related to visceral protein levels; however, the mechanisms and amount of influence are not completely defined. Methods. Constitutive and acute-phase protein levels were measured on days 1, 4, 7, and 10 in 68 severely injured patients with abdominal trauma indexes of 15 or more randomized to enteral or parenteral feeding. Groups were matched for age, abdominal trauma index, injury severity score, and length of stay. Results. Significantly higher levels of constitutive proteins and lower levels of acute-phase proteins were found in patients randomized to enteral feeding. Although some 'hepatic protein reprioritization' appeared to be caused by nutrient route, this appeared only in the less severely injured patients. A more important factor in visceral protein levels is a reduction in septic morbidity associated with enteral feeding. Conclusions. Enteral feeding produces greater increase in constitutive proteins and greater decreases in acute-phase proteins after severe trauma primarily caused by reduced septic morbidity with enteral feeding.

Original languageEnglish (US)
Pages (from-to)516-523
Number of pages8
JournalSurgery
Volume116
Issue number3
StatePublished - Sep 19 1994

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Parenteral Nutrition
Enteral Nutrition
Small Intestine
Sepsis
Acute-Phase Proteins
Wounds and Injuries
Proteins
Morbidity
Food
Injury Severity Score
Length of Stay
Research Design
Liver

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kudsk, K. A., Minard, G., Wojtysiak, S. L., Croce, M., Fabian, T., & Brown, R. (1994). Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma. Surgery, 116(3), 516-523.

Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma. / Kudsk, K. A.; Minard, G.; Wojtysiak, S. L.; Croce, Martin; Fabian, Timothy; Brown, Rex.

In: Surgery, Vol. 116, No. 3, 19.09.1994, p. 516-523.

Research output: Contribution to journalArticle

Kudsk, KA, Minard, G, Wojtysiak, SL, Croce, M, Fabian, T & Brown, R 1994, 'Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma', Surgery, vol. 116, no. 3, pp. 516-523.
Kudsk KA, Minard G, Wojtysiak SL, Croce M, Fabian T, Brown R. Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma. Surgery. 1994 Sep 19;116(3):516-523.
Kudsk, K. A. ; Minard, G. ; Wojtysiak, S. L. ; Croce, Martin ; Fabian, Timothy ; Brown, Rex. / Visceral protein response to enteral versus parenteral nutrition and sepsis in patients with trauma. In: Surgery. 1994 ; Vol. 116, No. 3. pp. 516-523.
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N2 - Background. Sepsis and the route of nutrient administration are clearly related to visceral protein levels; however, the mechanisms and amount of influence are not completely defined. Methods. Constitutive and acute-phase protein levels were measured on days 1, 4, 7, and 10 in 68 severely injured patients with abdominal trauma indexes of 15 or more randomized to enteral or parenteral feeding. Groups were matched for age, abdominal trauma index, injury severity score, and length of stay. Results. Significantly higher levels of constitutive proteins and lower levels of acute-phase proteins were found in patients randomized to enteral feeding. Although some 'hepatic protein reprioritization' appeared to be caused by nutrient route, this appeared only in the less severely injured patients. A more important factor in visceral protein levels is a reduction in septic morbidity associated with enteral feeding. Conclusions. Enteral feeding produces greater increase in constitutive proteins and greater decreases in acute-phase proteins after severe trauma primarily caused by reduced septic morbidity with enteral feeding.

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