The immune oriented nutrition support for patients with severe acute nontraumatic intracranial hemorrhage


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Abstract

The actual work presents the results of using various programs of nutrition support for patients with severe nontraumatic
intracranial hemorrhage. The huge reduction of both cellular and humoral immunity is established in the first day of the
onset of the disease. The authors assess the impact of the combined enteral-parenteral nutritive support with dipeptide
alanine-glutamine on immune rates and severity of nutrition deficiency. The work deals with the comparative characteristics
of complications of these nutrition programs. It is established, that application of alanine-glutamine in complex intensive
therapy reduces the frequency of pneumonia, delays pneumonia development, reduces the duration of mechanical ventilation
and the time of ICU stay.

About the authors

Воронежская государственная медицинской академии им. Н.Н.Бурденко Белгородская областная клиническая больница Святителя Иоасафа

Author for correspondence.
Email: author@vestnik-surgery.com

д.м.н., проф., зав. ка-федрой анестезиологии и реаниматологии ИДМО
Воронежской государственной медицинской акаде-мии им. Н.Н.Бурденко; e-mail: u_struk@mail.ru

Воронежская государственная медицинской академии им. Н.Н.Бурденко Белгородская областная клиническая больница Святителя Иоасафа

Email: author@vestnik-surgery.com

врач анестезио-лог-реаниматолог, заведующий отделением анесте-зиологии-реанимации №4 Белгородской областной
клинической больницы Святителя Иоасафа; e-mail:
aro.bokb@mail.ru

References

  1. Belkin A. A., Volkova L. I., Leiderman I. N. Insul't:
  2. Kliniko-organizatsionnoe rukovodstvo po okazaniiu
  3. meditsinskoi pomoshchi patsientam s ostrym narushe-niem mozgovogo krovoobrashcheniia(profilaktika, dia-gnostika, lechenie) na dogospital'nom i gospital'nom
  4. etapakh [Clinical-organizational manual on providing
  5. care of patients with acute stroke (prevention, diagnosis and treatment) in the pre-hospital and hospital
  6. stages]. Ekaterinburg: Izdatel'stvo Ural'skogo uni-versiteta, 2006; 101.
  7. Vorlou Ch.P. Insul't. Prakticheskoe rukovodstvo dlia
  8. vedeniia bol'nykh [How to
  9. management patients].- SPb.: Politekhnika1998; 629.
  10. Gusev E.I., Skvortsova V.I. Epidemiologiia insul'ta v
  11. Rossii [Epidemiology of stroke in
  12. Russia]. Consilium Medicum. 2003; 5: 5: 5-7.
  13. Gusev E.I., Skvortsova V.I., Krylov V.V. Snizhenie
  14. smertnosti i invalidnosti ot sosudistykh zaboleva-nii mozga v Rossiiskoi Federatsii [decrease of
  15. mortality and disability from cerebrovascular diseases in the Russian Federation]. Nevrologicheskii
  16. vestnik– 2007; XXXIX: 1: 128-133.
  17. Ivanina T. A., Evteeva E. A., Sen'chukov S.V., Petrikov
  18. S. S. Priznaki belkovo- energeticheskoi nedostatoch-nosti u bol'nykh gemorragicheskimi insul'tami. Ma-terialy piatogo mezhdunarodnogo kongressa po paren-teral'nomu i enteral'nomu pitaniiu [Signs of malnutrition in patients with hemorrhagic stroke. Proceedings of the fifth International Congress on Parenteral and Enteral Nutrition]. Moskva. 2001; 43 - 44.
  19. Insul't: diagnostika, lechenie, profilaktika [Stroke: Diagnosis, Treatment, Prevention] M.:
  20. MEDpress-inform, 2008; 288.
  21. Koval'chuk V.V., Skoromets A.A. Insul't: epidemiolo-giia, faktory riska i organizatsiia meditsinskoi pomo-shchi [Stroke: epidemiology, risk factors and the organization of health care]. Nevrologicheskii zhurnal2006; 6: 46-49.
  22. Kreidich S.A., Dubov A.M. Aktual'nost' klinicheskogo
  23. pitaniia pri ostrykh narusheniiakh mozgovogo krovoo-brashcheniia [The urgency of the clinical
  24. Power in acute cerebral circulatory disorders]. Meditsina neotlozhnykh sostoianii2006; 5:
  25. : 65-67.
  26. Krylov V.V. Problemy khirurgii netravmaticheskikh
  27. vnutricherepnykh krovoizliianii [Problems of non-traumatic surgery
  28. intracranial hemorrhage]. Materialy master-klassa po neiroanesteziologii i neiroreanimatolo-gii. SPb, 2009; 147-154.
  29. Krylov V.V. Khirurgiia gemorragicheskogo insul'ta [Surgery hemorrhagic stroke]. Me-ditsinskaia gazeta №57 (7087), 2010.
  30. Lebedev V.V., Krylov V.V. Neotlozhnaia neirokhirurgiia
  31. Rukovodstvo dlia vrachei [Emergency neurosurgery
  32. Guidelines for doctors]. M.: Meditsina, 2000; 568.
  33. Lozhkin S.N., Tikanadze A.D., Tiuriumina M.I. Gluta-min i ego rol' v intensivnoi terapii [Glutamine and its role in the intensive care]. Vestnik inten-sivnoi terapii2003; 4: 64-69.
  34. Luft V.M. Osnovy enteral'nogo pitaniia patsientov s
  35. narusheniem mozgovogo krovoobrashcheniia [Fundamentals of enteral nutrition in patients with
  36. cerebrovascular]. Materialy
  37. master-klassa po neiroanesteziologii i neiroreani-matologii. SPb, 2009; 155-171.
  38. O merakh po sovershenstvovaniiu lechebnogo pitaniia v
  39. lechebno-profilakticheskikh uchrezhdeniiakh Rossiiskoi
  40. Federatsii: Prikaz Ministerstva zdravookhraneniia
  41. Rossiiskoi Federatsii ot5 avgusta2003 [On measures to improve the nutritional care in
  42. medical institutions of the Russian
  43. Federation: Order of the Ministry of Health
  44. Russian Federation dated August 5, 2003] g. N 330. Ros.
  45. gaz. 2003; 192: 10.
  46. Osnovy klinicheskogo pitaniia: Materialy lektsii dlia
  47. kursov Evropeiskoi assotsiatsii parenteral'nogo i
  48. enteral'nogo pitaniia [Fundamentals of Clinical Nutrition: Materials for lectures
  49. courses of the European Association of parenteral and
  50. enteral feeding]. Petrozavodsk: IntelTek, 2003;
  51. : 29-30.
  52. Piradov M.A. Gemorragicheskii insul't: novye podkho-dy k diagnostike i lecheniiu [Hemorrhagic stroke: new approaches to diagnosis and treatment]. Atmosfera. Nervnye bo-lezni2005; 5: 17-19.
  53. Popova T.S., Shestopalov A.E. i dr. Nutritivnaia pod-derzhka bol'nykh v kriticheskikh sostoianiiakh [Nutritional support in critically ill patients]. M.: OOO
  54. «Izdat. Dom«M-Vesti», 2002; 320: 240.
  55. Saltanov A.I. Sel'chuk V.Iu, Snegovoi A.V. Osnovy
  56. nutritivnoi podderzhki v onkologicheskoi klinike [Foundation
  57. nutritional support in the oncological clinic]
  58. M.:MEDpress-inform, 2009; 240
  59. Saltanov A.I., Snegovoi A.V. Sovremennye vozmozhno-sti enteral'nogo pitaniia polimernymi i modul'ny-mi smesiami [Modern possibilities of enteral nutrition and modular polymer mixtures]. Trudnyi patsient2008; 6: 11: 47-50.
  60. Skvortsova V.I., Krylov V.V. Gemorragicheskii insul't [Hemorrhagic stroke]
  61. M.: GEOTAR-Media, 2005; 160.
  62. Shestopalov A.E, Pas'ko V.G., Grigor'ev A.I., Polovni-kov S.G. Glutamin dipeptid(Dipeptiven®
  63. ) v polnom
  64. parenteral'nom pitanii pri kriticheskikh sostoianiiakh [Glutamine dipeptide (Dipeptiven®
  65. ) full
  66. parenteral nutrition in critical conditions].
  67. Vestnik intensivnoi terapii2003; 1: 65-70.
  68. Shestopalov A.E. Enteral'naia korrektsiia narushenii
  69. immunnogo statusa v intensivnoi terapii kritiche-skikh sostoianii u khirurgicheskikh bol'nykh [Enteric correction of
  70. immune status ICU critical states in surgical patients]. Reanimatsiia
  71. na rubezheXXI veka. M., 1996; 351-353.
  72. Atkinson S., Sieffert E., Bihari D. Prospektivnoye randomizirovannoye, dvoynoye slepoye, kontroliruyemoye klinicheskoye issledovaniye enteral'nogo immunonutrition v kriticheskom sostoyanii [A prospective, randomized, double-blind, controlled clinical trial of enteral immunonutrition in the critically ill]. Critical Care Medicine.
  73. ;. 26: 7: 1164-1172.
  74. Beale R.J., Bryg D.J. Klinicheskiye effekty immunonutrition
  75. na patsiyentov intensivnoy terapii: meta-analiz [Clinical effects of immunonutrition
  76. on intensive care patients: a meta-analysis]. Intensive Care
  77. Med. 1997; 21: 136-44.
  78. Beale R.J., Bryg D.J., Bihan D. Immunonutrition v kriticheskom sostoyanii: sistematicheskiy obzor klinicheskikh iskhodov [Immunonutrition in the critically ill: A systematic review of clinical outcome]. Critical
  79. Care Medicine 1999; 27: 12: 2799-2805.
  80. Bistrian B.R., Blackburn G.L., Scrimshaw N.S. et al.Kletochnyy immunitet v polugolodnyh sostoyaniyah u gospitalizirovannykh vzroslykh [Cellular immunity in semistarved states in hospitalized adults].
  81. Am. J. Clin. Nutr. 1975; 28: 1148-1155.
  82. Brand K. Glyutamin i metabolizm glyukozy v protsesse proliferatsii timotsitov: puti glutamina i glutamata
  83. metabolizm [Glutamine and glucose metabolism during thymocyte proliferation: pathways of glutamine and glutamate
  84. metabolism]. Biochem. J. 1985; 228: 353.
  85. Cafiero F., Gipponi M., Bonalumi U. et al. Profilaktika
  86. Infektsiyy s vnutrivennymi immunoglobulinami plyus antibiotik dlya patsiyentov s riskom sepsisa, perenesshikh operatsiyu po
  87. kolorektal'nomu raku: rezul'taty randomizirovannogo, mnogotsentrovogo klinicheskogo issledovaniya [Prophylaxis of
  88. infection with intravenous immunoglobulins plus antibiotic for patients at risk for sepsis undergoing surgery for
  89. colorectal cancer: results of a randomized, multicenter clinical trial]. Surgery 1992; 112: 24-31.
  90. Calder PC, Yaqoob P.Glutamin i immunnaya sistema.
  91. Aminokisloty [Glutamine and the immune system.
  92. Amino Acids]. 1999; 17: 3: 227-241.
  93. Choi-Kwon S et al.Sostoyaniye pitaniya pri ostrom insul'te: nedoyedaniye po sravneniyu s pereyedaniyem v razlichnykh podtipakh insul'ta [Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes].
  94. Acta Neurol Scand. 1998; 98: 3: 187-192.
  95. Dubourg J, Messerer M. Sovremennoye sostoyaniye v upravlenii netravmaticheskogo vnutrimozgovogo krovoizliyaniya [State of the art in managing nontraumatic intracerebral hemorrhage]. Neurosurg Focus.2011;
  96. : 6: E22: 1-7.
  97. Field CJ, Johnson IR, Schley PD. Pitatel'nyye veshchestva i ikh rol' v ustoychivosti k infektsii [Nutrients and their role in
  98. host resistans to infection]. J. Leukoc. Biol. 2002; 71: 16-32.
  99. Hammarqvist F. et al. Alanil-glutamin protivodeystvuyet istoshcheniyu svobodnogo glutamina i posleoperatsionnomu snizheniyu sinteza belka v skeletnykh myshtsakh [Alanyl-glutamine counteracts the
  100. depletion of free glutamine and the postoperative decline in
  101. protein synthesis in skeletal muscle]. Ann.Surg. 1990; 212:
  102. -644.
  103. Marcos A., Nova E., Montero A. Izmeneniya v immunnoy sisteme obuslovlennyye pitaniyem [Changes in the immune
  104. system are conditioned by nutrition]. Eur J Clin Nutr. 2003;
  105. : 1: 66-69.
  106. Newsholme P et al. Glyutamin i glutamat, kak zhiznenno vazhnyye metabolity [Glutamine and glutamate as vital
  107. metabolites]. Braz J Med Biol Res. 2003; 36: 2: 153-163.
  108. Novak F et al. Glutamina v tyazheloy bolezni:
  109. Sistematicheskiy obzor fakticheskikh dannykh (meta-analiz) [Glutamine supplementation in serious illness:
  110. A systematic review of the evidence (meta-analysis)]. Crit
  111. Care Med. 2002; 30: 9: 2022-2029
  112. Petersson et al. Dolgosrochnyy effekt glitsil-glutamina posle planovoy operatsii svobodnykh aminokislot v myshechnoy tkani [Long-term effect of glycyl-glutamine after
  113. elective surgery free amino acids in muscle]. JPEN. – 1994;
  114. : 320-325.
  115. Piccirillo N et al. Glyutamin obogashchennogo parenteral'nogo pitaniya
  116. posle autotransplantatsii perifericheskoy krovi stvolovykh kletok:
  117. vozdeystviye na vosstanovleniye immunnoy sistemy i vospaleniya slizistoy obolochki [Glutamine-enriched parenteral nutrition
  118. after autologous peripheral blood stem cell transplantation:
  119. effects on immune reconstitution and mucositis].
  120. Haematologica. 2003; 88: 2: 192-200.
  121. Rincon F, Mayer SA. Klinicheskiy obzor: Upravleniye spontannogo vnutrimozgovogo krovoizliyaniya [Clinical review: Critical care
  122. management of spontaneous intracerebral hemorrhage].
  123. Critical Care. 2008; 12: 237.
  124. Spittler A et al. Posleoperatsionnyy glitsil-glutamina nastoy
  125. umen'shayet immunosupressii: chastichnoye predotvrashcheniye khirurgicheskogo indutsirovannogo snizheniya urovnya ekspressii HLA-DR na monotsitakh [Postoperative glycyl-glutamine infusion
  126. reduces immunosuppression: partial prevention of the surgery induced decrease in HLA-DR expression on monocytes]. Clin Nutr. 2001; 20: 1:37-42.
  127. Wang Y et al.Vliyaniye glyutamina dipeptida-dobavlyayemoy parenteral'nogo pitaniya na iskhody khirurgicheskikh patsiyentov: meta-analiz randomizirovannykh klinicheskikh issledovaniy [The impact of glutamine dipeptide-supplemented parenteral nutrition on outcomes of surgical patients: a meta-analysis of randomized clinical trials]. J Parenter Enteral Nutr. – 2010; 34: 5: 521-529.
  128. Wernerman J. Rol' glutamina bol'nykh v kriticheskom sostoyanii [ Role of glutamine supplementation in critically ill patients]. Curr Opin Anaesthesiol. – 2008; 21: 155–
  129. Woodward B. Belki, kalorii, i immunnaya zashchita [Protein, calories, and immune defenses]. Nutr.
  130. Rev. – 1998; 56: 84-86

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