[Clinical application of enteral immune nutrition for chronic obstructive pulmonary disease patients].

OBJECTIVE: To explore the application of enteral immune nutrition preparation for chronic obstructive pulmonary disease (COPD) patients and examine the improving effects on nutritional status, immune status and acute inflammatory reaction.

METHODS: A total of 60 cases of hospitalized COPD patients on mechanical ventilation in intensive care unit (ICU) were randomly divided into immune nutrition group (containing essential fatty acids, omega-3 fatty acids, energy 1.3 kcal/ml) (study, n = 30) and standard nutrition group (self-made homogenized diet 1.2 kal/ml) (control, n = 30). Two groups received an equal calorie of enteral nutrition via a nasointestinal tube. On the day of admission and every 2 weeks, venous blood samples were drawn for measuring the serum levels of albumin (ALB), prealbumin (PA), C-reactive protein (CRP) and interleukin-6 (IL-6). And the values of upper arm muscle circumference (MAMC) were recorded simultaneously bedside. The levels of mechanical ventilation and weaning rate were compared between two groups at Day 14.

RESULTS: The weaning rate within 14 days in study group was higher than that in control group (73.3% vs 43.3%, P < 0.05). And PA at Day 14 in study group was higher than that in control group [(188.4 ± 57.5) vs (174.6 ± 65.7) mg/L, P < 0.05], ALB at Day 14 also higher than control group [(32.7 ± 4.6) vs (30.2 ± 3.8) g/L, P < 0.05], MAMC at Day 28 better than control group [(25.5 ± 2.1) cm vs (24.3 ± 1.8) cm, P < 0.05]. No significant inter-group difference in IL-6 existed at Day 14 [(250.1 ± 110.3) vs (266.1 ± 97.3) ng/L, P > 0.05]. The study group was lower than control group at Day 28 [(108.5 ± 59.6) vs (165.7 ± 76.3) ng/L, P < 0.05]. The CRP levels at Day 14 [(12.2 ± 7.3) vs (13.2 ± 6.9) mg/L, P < 0.05] and at Day 28 [(7.5 ± 5.0) vs (9.6 ± 5.6) mg/L, P < 0.05] were lower than those of control group at Days 14 and 28.

CONCLUSION: Compared with homogenized diet, immune enteral nutrition may improve the nutritional status of COPD patients, lower the levels of acute inflammatory reactions and boost the success rate of early weaning.