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

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.

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.

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.

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.