Nutrition
Volume 22, Issue 7 , Pages 705-712 , July 2006

Controlled study of enteral arginine supplementation in burned children: impact on immunologic and metabolic status

  • Veronica B. Marin, M.D.

      Affiliations

    • INTA, University of Chile, Santiago, Chile
    • Department of Pediatrics, University of Chile, Santiago, Chile
    • Corresponding Author InformationCorresponding author. Tel.: +56-2-758-8574; fax: +56-2-630-0474.
  • ,
  • Lorena Rodriguez-Osiac, M.D.

      Affiliations

    • INTA, University of Chile, Santiago, Chile
  • ,
  • Liana Schlessinger, M.D.

      Affiliations

    • INTA, University of Chile, Santiago, Chile
  • ,
  • Jorge Villegas, M.D.

      Affiliations

    • Department of Pediatric Surgery, Luis Calvo Mackenna Childrens Hospital, Santiago, Chile
  • ,
  • Marcelo Lopez, M.D.

      Affiliations

    • INTA, University of Chile, Santiago, Chile
  • ,
  • Carlos Castillo-Duran, M.D.

      Affiliations

    • INTA, University of Chile, Santiago, Chile

Received 21 December 2005 ,Accepted 24 March 2006.

References 

  1. Barak N , Wall-Alonso E , Sitrin M . Evaluation of stress factors and body weight adjustments currently used to estimate energy expenditure in hospitalized patients . JPEN . 2002;26:231–238
  2. Coss-Bu JA , Jefferson LS , Walding D , David Y , Smith EO , Klish WJ . Resting energy expenditure and nitrogen balance in critically ill pediatric patient on mechanical ventilation . Nutrition . 1998;14:649–652
  3. Milner EA , Cioffi WG , Mason AD , McManus WF , Pruitt BA . Accuracy of urinary nitrogen for predicting total urinary nitrogen in thermally injured patients . JPEN . 1993;17:414–416
  4. Tredget EE , Yu YM . The metabolic effects of thermal injury . World J Surg . 1992;16:68–79
  5. Askarian M , Hosseini RS , Kheirandish P , Assadian O . Incidence and outcome of nosocomial infections in female burn patients in Shiraz, Iran . Am J Infect Control . 2004;32:23–26
  6. Zedler S , Bone RC , Baue AE , von Donnersmarck GH , Faist E . T-cell reactivity and its predictive role in immunosuppression after burns . Crit Care Med . 1999;27:66–72
  7. Barlow Y . T lymphocytes and immunosuppression in the burned patient (a review) . Burns . 1994;20:487–490
  8. Molloy RG , Nestor M , Collins KH , Holzeimer RG , Mannick JA , Rodrick ML . The humoral immune response after thermal injury (an experimental model) . Surgery . 1994;115:341–348
  9. O’Sullivan ST , O’Connor TP . Immunosuppression following thermal injury (the pathogenesis of immunodysfunction) . Br J Plast Surg . 1997;50:615–623
  10. Oberholzer A , Oberholzer C , Moldawer LL . Citokine signaling-regulation of the immune response in normal and critically ill states . Crit Care Med . 2000;28:3–12
  11. De Bandt JP , Chollet-Martin S , Hernvann A , Lioret N , du Roure LD , Lim SK , et al.   Cytokine response to burn injuries . J Trauma . 1994;36:624–628
  12. Struzyna J , Pojda Z , Braun B , Chomicka M , Sobiczewska E , Wrembel J . Serum cytokine levels (IL-4, IL-6, IL-8, G-CSF, GM-CSF) in burned patients . Burns . 1995;21:437–440
  13. Bower RH . Nutrition during critical illness and sepsis . New Horiz . 1993;1:348–352
  14. Enzi G , Casadei A , Sergi G , Chiarelli A , Zurlo F , Mazzoleni F . Metabolic and hormonal effects of early nutritional supplementation after surgery in burn patients . Crit Care Med . 1990;18:719–721
  15. Dudrick PS , Souba WW . Amino acids in surgical nutrition (principles and practice) . Surg Clin North Am . 1991;71:459–476
  16. Mochizuki H , Trocki O , Dominioni L , Brackett KA , Joffe SN , Alexander JW . Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding . Ann Surg . 1984;200:297–308
  17. Saito H , Trocki O , Alexander JW , Kopcha R , Heyd T , Joffe SN . The effect of nutrient administration on the nutritional state, catabolic hormone secretion and gut mucosal integrity after burn injury . JPEN . 1987;11:1–7
  18. Beale RJ , Bryg DJ , Bihari DJ . Immunonutrition in the critically ill (a systematic review of clinical outcome) . Crit Care Med . 1999;27:2799–2805
  19. Galban C , Montejo JC , Mesejo A , Marco P , Celaya S , Sanchez-Segura JM , et al.   An immune-enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients . Crit Care Med . 2000;28:643–648
  20. Kudsk KA , Minard G , Croce MA , Brown RO , Lowrey TS , Pritchard FE , et al.   A randomized trial of isonitrogenous enteral diets after severe trauma an immune-enhancing diet reduces septic complications . Ann Surg . 1996;224:531–543
  21. Evoy D , Lieberman MD , Fahey TJ , Daly JM . Immunonutrition (the role of arginine) . Nutrition . 1998;14:611–617
  22. Yu YM , Sheridan RL , Burke JF , Chapman TE , Tompkins RG , Young VR . Kinetics of plasma arginine and leucine in pediatric burn patients . Am J Clin Nutr . 1996;64:60–66
  23. Cui XL . Arginine-supplemented diet decreases expression of inflammatory cytokines and improves survival in burned rats . JPEN . 2000;24:89–96
  24. Saffle JR , Wiebke G , Jennings K , Morris SE , Barton RG . Randomized trial of immune-enhancing enteral nutrition in burn patients . J Trauma . 1997;42:793–802
  25. Bower RH , Cerra FB , Bershadsky B , Licari JJ , Hoyt DB , Jensen GL , et al.   Early enteral administration of formula (Impact) supplemented with arginine, nucleotides, and fish oil in intensive care unit patients (results of multicenter, prospective, randomized, clinical trial) . Crit Care Med . 1995;3:436–449
  26. Elsair J , Poey J , Issad H . Effect of arginine chlorhydrate on nitrogen balance during the three days following routine surgery in man . Biomed Express . 1978;29:312–317
  27. Saito H , Trocki O , Wang SL , Gonce SJ , Joffe SN , Alexander JW . Metabolic and immune effects of dietary arginine supplementation after burn . Arch Surg . 1987;22:784–789
  28. Adjei AA , Yamauchi K , Nakasone Y , Konishi M , Yamamoto S . Arginine-supplemented diets inhibit endotoxin-induced bacterial translocation in mice . Nutrition . 1995;11:371–374
  29. Holland KA , Gillespie RW , Lewis NM , Kachman SD . Estimating energy needs of pediatric patients with burns . J Burn Care Rehabil . 1995;16:458–460
  30. Oppenheim JJ , Rosentreich DL . In:  Bloom BR ,  Davis JR editor. Lymphocyte transformation (utilization of automatic cell harvesters. In vitro methods in cell-mediated tumor immunity) . New York: Academic Press; 1976;p. 73–85
  31. Mediciŏn del cambio del estado nutricional . Ginebra: World Health Organization; Ginebra; 1983;
  32. Chwals WJ , Fernandez ME , Charles BJ , Schroeder LA , Turner CS . Serum visceral protein levels reflect protein calorie repletion in neonates recovering from major surgery . J Pediatr Surg . 1992;27:317–321
  33. Anand KJ , Hansen DD , Hickey PR . Hormonal-metabolic stress responses in neonates undergoing cardiac surgery . Anesthesiology . 1990;73:661–670
  34. Chwals WJ , Letton RW , Jamie A , Charles B . Stratification of injury severity using energy expenditure response in surgical infants . J Pediatr Surg . 1995;30:1161–1164
  35. Andel H , Kamolz LP , Horauf K , Zimpfer M . Nutrition and anabolic agents in burned patients . Burns . 1993;29:592–595
  36. Daly JM , Reynolds J , Thom A , Kinsley L , Dietrick-Gallager M . Immune and metabolic effects of arginine in surgical patient . Ann Surg . 1988;208:512–523
  37. Jeschke MG , Herndon DN , Ebener C , Barrow RE , Jauch KW . Nutritional intervention high in vitamins, protein, amino acids, and omega-3 fatty acids improves protein metabolism during the hypermetabolic state after thermal injury . Arch Surg . 2001;136:1301–1306
  38. Alexander JW . Nutritional pharmacology in surgical patients . Am J Surg . 2002;183:349–352
  39. Tsai HJ , Shang HF , Yeh CL , Yeh SL . Effects of arginine supplementation on antioxidant enzyme activity and macrophage response in burned mice . Burns . 2002;28:258–263
  40. Nieves C , Langkamp-Henken B . Arginine and immunity (a unique perspective) . Biomed Pharmacother . 2002;56:471–482
  41. Barbul A , Sisto DA , Wasserkrug HL , Yoshimura NN , Efron G . Metabolic and immune effects of arginine in post-injury hyperalimentation . J Trauma . 1981;21:970–974
  42. Cen Y , Luo XS , Liu XX . Effect of L-arginine supplementation on partial-thickness burned patients . Chin J Reparat Reconstr Surg . 1999;13:227–231
  43. Yu YM, Ryan CM, Castillo L, Lu XM, Beaumier L, Tompkins RG, et al. Arginine and ornithine kinetics in severely burned patients (increased rate of arginine disposal) . Am J Physiol Endocrinol Metab . 2001;280:E509–E517
  44. Kirk SJ , Regan MC , Wasserkrug HL , Sodeyama M , Barbul A . Arginine enhances T-cell responses in athymic nude mice . JPEN . 1992;16:429–432
  45. Gianotti L , Alexander JW , Pyles T , Fukushima R . Arginine-supplemented diets improve survival in gut-derived sepsis and peritonitis by modulating bacterial clearance. The role of nitric oxide . Ann Surg . 1993;217:644–654
  46. Yan H , Peng X , Wang P , Huang YS , Wang SL . Influence of the enteral feeding of levorotatory arginine on severely burned patients during shock stage . Zhonghua Shao Shang Za Zhi . 2005;21:251–254
  47. Wu JZ , Ogle CK , Mao JX , Szczur K , Fischer JE , Ogle JD . The increased potential for the production of inflammatory cytokines by Kupffer cells and splenic macrophages eight days after thermal injury . Inflammation . 1995;19:529–541

 This study was funded in part by grant 1990081 from FONDECYT.

PII: S0899-9007(06)00165-1

doi: 10.1016/j.nut.2006.03.009

Nutrition
Volume 22, Issue 7 , Pages 705-712 , July 2006