Immunomodulation of glutamine and taurine in total parenteral nutrition for the rats

ABSTRACTS FROM THE 7TH CONGRESS OF THE CHINESE SOCIETY OF PARENTERAL AND ENTJZRALNUTRITION 741

NTUH Experkncc of -ong-Chain

T+$yc&de

inTPNFonu& Hona-Shiee Lai,WeiJao Depemnentof SW,

The Value of Prognostic Nutritional Index in Surgery for Colorectal Cancer HsinChi Hsieh , TzcChi Hsu, Li-Fen Tti, Shwu-Ching Leu, Yu-Show Hsieh

Chen

NutritionalSupport Service, Mackay Memorial Hospital, Taipei, Taiwan

National TaiwanUniversityHo@tal Prognostic

Fat~onisauimportantenergyeauro3intotalpsrenteral fomullainthepatientMtuP!illgm&iormugery. Impairmentdlivsr funui~howevar,aaxrredin~patients,~yinsmaU Forevaiuatingthemetabolicaudnutritional&ectsof Cllil~. MCTiLCT vs LCT &t emulsion in the poetoparativeehildfen and infants, thirty-fourp&3nts who receivedthoracicor ewaninal surgery ~indudatinthis&udy. Inthetotalpamn&alnutrition(TPN) &ml&10%Lip&adi.nMcr/Lcrweregivenin22patien@and10?/0 Li~SLcT~giMnin12patients~yformorethan~ w#drs. OtherTPNconten@,includinggluaxeaadaminoacids,were

quantitative

rmtritional index (PNI) was designed

determination

of the risk of nutritionally

morbidity and mortality in individual patients. The index necessitates the measurement

of

10 nutritional

parameters

and

numerous

types

of

nonnutritional data. Many reports suggested that PNI provides an accurate estimate of the operative risk for patients undergoing gastrointestinal surgery. In this study, from April 1994 to August 1995, a total of 113 patients undergoing

nonemergency

preoperatively usage diierent

anmts,semmnonca&ifledfattyacid(NEpA),acetoaatate(M). 8hydmaybutyrasc,livarfuactionindicatarsondayO,3.7,14;(2)urine cre&l&aadnitroj9lloutputonday0to7,audday14;(3)cal~ ferr@atoryquotient(RQ)andenergysub&ateutilizasion. WeGound tithel~pCXWn@eiIlp3riph&blODdbeaunehighGlin MIX/XT than in LCT m patienti on day 14(P~0.05);the metabolic rata of fat was hudsr in MCmCT patients (p
to predict the based operative

surgery

for colorectal

cancer were asses&

nutritional parameters. 53 patientswere male

and 60 female. 55 patients had rectal carcinomas and 58 patients had colon carcinomas. Ages ranged Eom 29 to 90 years old with an ax-rage of 61.23 years. 64 patients having PNI of less than 40% were at low risk and had a complication rate of 21.88% 1.56%.

32 patients

, a sepsis rate of 7.81%, and a mortality rate of

in the high risk group

(PNI>50%)

suffered

a

complication rate of 34.38%. a sepsis rate of 21.88%, and a mortality rate of 6.25% 17 patients in the intermediate group (PNI of 40 to 49%) sustained a 29.41% complication rate, a 29.41% sepsis rate, and a 5.88% mortality rate. The series suggests that PNI may be a us&d method for predicting surgical mortality

and morbidity,

especially

septic

complications

in patients

undergoing nonemergency surgery for colorectal cancer.

Percutaneous Endoscopic Gastrostomy and Jejunostomy Mei-Hua Chueng, Shung-Sheng Tsou. Wei-Kuo Chang, Tzu-Ming Chang Nutrition Support Team Tri-service General Hospital N-G feeding are most commonly employed for home enteral nutrition in Taiwan. Repeated nasogastric tube intubation bothered patients themself and family members. They worried about the potential complications with nasogastric tube intubation, including sinusitis ,malposition of the tube in a lung, pulmonary aspiration, esophageal and gastric perforation The development of Percutaneous Endoscopic Gastrostomy and Jejunostomy (PEGIPEJ) has provided a safe and comfortable route for the administration of enteral alimentation. The relative simplicity of PEG/PEJ placement without the need for standard surgical approaches and general anesthesia is one of the most attractive features of this technique. This presentation, we reported four comatous cases who suffered from loss of body weight due to difficulty of repeated nasogastric tube intubation. All of them improved their caloric intake after PEG applied. We also described the details of PEG and PE.J procedures and compared the benefits of various enteral access for long-term nutrient delivery.

Immuaomodulatioa of Glutamine and Taurine in Total Parenteral Nutrition for the rats Tsann-w Ho&hung Yu, Wei-Jen Lai. Department of Nutritional Therapy, Chang Gung Memorial Hospital, Taipei, Taiwan Major surgery, multiple trauma and sepsis may result in metabolic and immunologic sequelae, which increase the mortality and morbidity. For the patients who need total parenteral nutrition, the enhancement of their immune function is the new challenge of critical care. Gtutamine is one of the primary &el for the lymphocytes, macrophages and enterocytes. Taurine is also an abundant free amino acid in the intracellular compartment. The effects of ghitamine with or without taurine nutrition on total parenteral the supplemented immunomodulation was designed to study. The rats were randomly divided into four groups a&r central venous catheter was set up. They were allow only sip water and infused with standard total parenteral nutritional solution added by gh&mine at 2% v&/v01(Gp. A); or glycine at 2% v&v01 and taurine at 8.6 mgkg/day (Gp. B); or glutamine at 2% wt/vol and taurine at 8.6 mg/kg/day (Gp. C) or glycine at 2% wt/vol (Gp. D) for 7 days. The in&ion rate was 2 ml/hr. Their immunologic fbnctions with NBT phagocytotic test were checked after 7 days infusion. The results showed that the rats of group C had better unstimulated (30.8f8.1% vs 7.3ti.l%) and stimulated @S&11.3% vs 21M.l%) NBT test compared to those in group D. (P < 0.05) The weight of liver, spleen among four groups had no significant difference. Our conclusions are that the glutamine plus taurine enriched TPN can induce better immunomodulation for the rats which need parenteral nutritional support.