Nutritional and Immunologic Status in the Acute Phase of Severe Sepsis : Significance of Nutritional Support and Assesment
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概要
- 論文の詳細を見る
We considered the significance of nutritional support and assessment in the acute phase of severe sepsis, investigating the nutritional and immunologic status of these patients. Blood was sampled from patients with severe sepsis within 3 days after removal or drainage of foci of infection and/or administraton of adequate antibiotics, and again in another 7 to 10 days. Rates of change (%) for laboratory data were calculated between these time points. Clinical, nutritional, and immunologic data, nutritional management, and clinical outcome were investigated. Characteristics of patients did not differ significantly between patients with improvement (group I, n=22) and patients with no improvement (group N, n=17). Rates of change in total protein, albumin, prealbumin, retinol binding protein (RBP), transferrin, and total cholesterol were significantly less in group N than in group I. Rates of change of CD4 and CD4/CD8 were significantly greater in the N group than in the I group. Enteral predominated over parenteral nutrition in the I group but not the N group. The ratio of mean caloric intake to calories measured by indirect calorimetry was lower in the N group than in the I group. Rate of change in retinol binding protein, a rapidturnover protein, correlated with rates of change in complement (C3 and C4). Mortality was higher in group N than group I. The rate of change in IL-10 correlated negatively with that of total cholesterol. Nutritional status is related to immunologic status and clinical outcome in patients in the acute phase of severe sepsis. Uncontrolled sepsis worsens nutritional status, contributing to poor prognosis. Total cholesterol and rapid turnover proteins reflected nutritional status and predicted clinical outcome. Nutritional support and assessment can be pivotal significant in the acute phase of severe sepsis.
- 北里大学の論文
- 2003-08-31
著者
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Soma Kazui
Department Of Emergency And Critical Care Medicine Kitasato University School Of Medicine
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Kataoka Yuichi
Department Of Emergency And Critical Care Medicine Kitasato University School Of Medicine
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Sakamoto Namiko
Department Of Critical Care And Emergency Medicine Tsukuba Medical Center
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Sakamoto Namiko
Department Of Emergency And Critical Care Medicine Kitasato University School Of Medicine
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Soma Kazui
Department Of Critical Care And Emergency Kitasato University School Of Medicine
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