EVALUATION OF PAR ENTRAL NUTRITON ON IMMUNE SYSTEM IN PATIENTS WITH POLY TRAUMA

Abstract

Nutritional' support for trauma and critically ill patients has been advocated to promote immune system recovery and to prevent as much tissue break down and nutritional deficit, the present study aiming to assessment of the parenteral nutrition on the immune system of patient with multiple trauma. Compare the effect of early parenteral nutritional and conventional hospital diet on the nutrition and immunology markers in trm:ma patients. A convenient sample of 40 severely traumatized patients within 8 hours after trauma they were enrolled sequentially into a conventional (n = 20) and an total parenteral nutrition (n = 20)

groups (TPN). Criteria for subject inclusion were, age 18-< 45 years, injury severity score (ISS) 20-40 score. Tools ofdata collection, four tools were utilized to collect data pertinent to the study. These toolswere nutritional assessment sheet, trauma scales and (APACHE) score (checklist), parenteral nutrition plans, evaluation tool, which includes (Anthropometric measurement, Laboratory studies, Immunological parameters). Total parenteral nutritional has positive impact for trauma patients on anthropometric measurement, {weight loss, TSF and MAC) which was observed at the end of therapy (th day) for the conventional group while there were no changes for the same parameters in TPN group. As regard, laboratory tests, there were significant increase in the value of total serum protein and albumin among patients of the TPN group after the end of therapy at th

day. As regard immune function, it was found that the mean values of(IL-10, IL-6, CDs) were significantly dropped in the TPN group after the end of therapy as compared to the admission. Also there were significant increase in the values of complement C3, IGA, CD4 111

and CD4 /CD8 ratio among patient of the TPN group at 7

day. Establishment and

implement of standardized protocol of parenteral nutrition support using nutritional screening and physical assessment forms, for the critically ill patients.