NUTRITION= zyxw THE INTERNATIONAL JOURNAL OF APPLIED AND BASIC NUTRITIONAL SCIENCES Volume 14 February 1998 Number 2 APPLIED NUTRITIONAL INVESTIGATION Nutrition Vol. 14, No. 2, 1998 Influence of Arginine, Omega-3 Fatty Acids and Nucleotide-Supplemented Enteral Support on Systemic Inflammatory Response Syndrome and Multiple Organ Failure in Patients After Severe Trauma ARVED WEIMANN, MD,* LEONARD BASTIAN, MD,? WERNER E. BISCHOFF, MD,$ MARTIN GROTZ, MD,? MATTHIAS HANSEL, MD,* JOACHIM LOTZ, MD,* CHRISTIAN TRAUTWEIN, GiiNTER TUSCH, MS,* HANS J. SCHLITT, MD,* AND GERD REGEL, MD-f From the “Klinik fiir Abdominal- und Transplantationschirurgie, fUn.allchirurgische Klinik, $Institut fiir Mikrobiologie, and Abteilung Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover, Hannover, Germany Date accepted: 22 May 1997 ABSTRACT This study investigated the influence of an enteral diet supplemented with arginine, omega-3 fatty acids, and nucleotides (Impact, Sandoz Nutrition, Beme, Switzerland) on the incidence of systemic inflammatory response syndrome (SIRS) and multiple organ failure (MOF) in patients after severe trauma. Thirty-two patients with an injury-severity score >20 were included in this prospective, randomized, double-blind, controlled study. Primary endpoints were the incidence of SIRS and MOF. Secondary endpoints were parameters of acute phase and immune response as well as infection rate, mortality, and hospital stay. For statistical analysis 29 patients (test group n = 16, control n = 13) were eligible. In the test group, significantly fewer SIRS days per patient were found during 28 d. The difference was highly significant between d 8-14 (P < 0.001). MOF score was significantly lower in the test group on d 3 and d 8-l 1 (P < 0.05). Acute phase parameters showed lower C-reactive protein serum levels (significant on D day 4) and fibrinogen plasma levels (significant on d 12 and 14; P < 0.05). HLA-DR expression on monocytes showed significantly higher fluorescence activity on d 7. No significant difference was found for T-lymphocyte CD4/CD8 ratio, interleukin-2 receptor expression, infection rate, mortality (2/16 vs. 403) and hospital stay. The results of the study provide further support for beneficial effects of arginine, omega-3-fatty acids and nucleotide-supplemented enteral diet in critically ill patients. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Nutrition 1998;14:165-172. OElsevier Science Inc. 1998 Correspondence to: Arved Weimann, MD, Klinik fur Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Nutrition 14:165-172, 1998 OElsevier Science Inc. 1998 Printed in the USA. All rights reserved. ELSEVIER 0899.9007/98/$19.00 PI1 SO899-9007(97)00429-2