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Safety and intestinal tolerance of high-dose enteral antioxidants and glutamine peptides after upper gastrointestinal surgery

European Journal of Clinical Nutrition volume 59, pages 307–310 (2005)Cite this article

Abstract

Objective: Safety and intestinal tolerance of an early high-dose enteral administration of antioxidative vitamins, trace elements, and glutamine dipeptides.

Design: open intervention trial.

Setting: Two university teaching hospitals.

Patients: A total of 14 patients requiring jejunal feeding (64±14 y).

Intervention: A measure of 500 ml/day Intestamin® (FreseniusKabi: 250 kcal/1.050 kJ, 300 μg selenium, 20 mg zinc, 400 μg chromium, 1500 mg vitamin C, 500 mg vitamin E, 10 mg β-carotene, 30 g glutamine) for 5 days beginning 6 h after surgery. Parenteral/enteral nutrition was provided to achieve energy target (25 kcal/kg/day).

Assessments: Intestinal complaints, plasma nutrients, and glutathione.

Results: Only minor signs of nausea, hiccups, flatulence (3/14). Plasma micronutrients (except β-carotene) postoperatively decreased and increased to normal on day 5. Extracellular glutamine remained low (preop: 520±94; d1: 357±67; d5: 389±79 μmol/l); total glutathione decreased (d1: 9.4±3.8; d5: 3.6±2.5 μmol/l).

Conclusion: Study feed is well tolerated and metabolically safe representing a valuable tool for targeted pharmaconutrient supply.

Sponsorship: The trials were carried out with the local University's human resources; Fresenius Kabi (Bad Homburg, Germany) partially supported the trial by financing the analytical determination and providing the supplementation solutions.

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Acknowledgements

The authors are grateful to Dr Ulrich Suchner for critical discussion of the results and revision of the manuscript, and to Julia Goette for help with data collection.

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Authors and Affiliations

  1. Universitätsklinik, Allgemeine Chirurgie und Thoraxchirurgie, Kiel, Germany

    J Schroeder

  2. Department of Nutrition Science, University of Bonn, Bonn, Germany

    B Alteheld & P Stehle

  3. Soins Intensifs Chirurgicaux, CHUV, Lausanne, Switzerland

    M -C Cayeux, R L Chioléro & M M Berger

Authors
  1. J Schroeder
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  2. B Alteheld
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  3. P Stehle
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  4. M -C Cayeux
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  5. R L Chioléro
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  6. M M Berger
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Corresponding author

Correspondence to M M Berger.

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Guarantor: MM Berger.

Contributors: JS contributed to the design of the trial, data collection, analysis of the results and redaction of the manuscript. BA contributed to solve the analytical issues. PS contributed to the design of the trial, to solve the analytical issues, analysis of the results and redaction of the manuscript. MCC and RLC contributed to design of the trial and data collection. MMB contributed to the design of the trial, data collection, analysis of the results, graphical display of the results and redaction of the manuscript.

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Schroeder, J., Alteheld, B., Stehle, P. et al. Safety and intestinal tolerance of high-dose enteral antioxidants and glutamine peptides after upper gastrointestinal surgery. Eur J Clin Nutr 59, 307–310 (2005). https://doi.org/10.1038/sj.ejcn.1602073

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