Immunonutrition and cytokine response in patients with head injury.

BACKGROUND To investigate whether short-term postoperative immunonutrients feeding can modulate the level of cytokines in patients with head injury compared to standard enteral tube feeding formula. MATERIAL AND METHOD A randomized double-blind study was carried out on 40 moderate to severe head injury patients. They were randomized to have continuous nasogastric tube feeding within 24 hours after surgery of either the immunonutrient containing enteral formula (group A) or the standard enteral formula (group B). The level of interleukin-6 (IL-6) and 10 (IL-10) were measured on day 1 (before feeding), and subsequently on day 3 and day 5. RESULTS Twenty patients were randomly selected in each group, who had similar severity levels of injury. Compared to the level of IL-6 on day 1, the level of IL-6 was markedly reduced on day 3 in group A (p = 0.002), whereas such reduction in group B was not statistically significant. CONCLUSION Short term postoperative immunonutrient feeding can reduce cytokine level, indicating that systemic inflammatory response syndrome might be modulated by such feeding.