Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial

Major surgery induces a long fasting time and provokes an inflammatory response which increases the risk of infections. Nutrition given before and during surgery can avoid fasting and has been shown to increase the arginine/asymmetric dimetlhylarginine ratio, a marker of nitric oxide availability, i...

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Main Authors: Marlieke Visser, Hans W. M. Niessen, Wouter E. M. Kok, Riccardo Cocchieri, Willem Wisselink, Paul A. M. van Leeuwen, Bas A. J. M. de Mol
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Nutrition and Metabolism
Online Access:http://dx.doi.org/10.1155/2015/123158
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author Marlieke Visser
Hans W. M. Niessen
Wouter E. M. Kok
Riccardo Cocchieri
Willem Wisselink
Paul A. M. van Leeuwen
Bas A. J. M. de Mol
author_facet Marlieke Visser
Hans W. M. Niessen
Wouter E. M. Kok
Riccardo Cocchieri
Willem Wisselink
Paul A. M. van Leeuwen
Bas A. J. M. de Mol
author_sort Marlieke Visser
collection DOAJ
description Major surgery induces a long fasting time and provokes an inflammatory response which increases the risk of infections. Nutrition given before and during surgery can avoid fasting and has been shown to increase the arginine/asymmetric dimetlhylarginine ratio, a marker of nitric oxide availability, in cardiac tissue and increased concentrations of branched chain amino acids in blood plasma. However, the effect of this new nutritional strategy on organ inflammatory response is unknown. Therefore, we studied the effect of nutrition before and during cardiac surgery on myocardial inflammatory response. In this trial, 32 patients were randomised between enteral, parenteral, and no nutrition supplementation (control) from 2 days before, during, up to 2 days after coronary artery bypass grafting. Both solutions included proteins or amino acids, glucose, vitamins, and minerals. Myocardial atrial tissue was sampled before and after revascularization and was analysed immunohistochemically, subdivided into cardiomyocytic, fatty, and fibrotic areas. Inflammatory cells, especially leukocytes, were present in cardiac tissue in all study groups. No significant differences were found in the myocardial inflammatory response between the enteral, parenteral, and control groups. In conclusion, nutrition given before and during surgery neither stimulates nor diminishes the myocardial inflammatory response in patients undergoing coronary artery bypass grafting. The trial was registered in Netherlands Trial Register (NTR): NTR2183.
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spelling doaj-art-8c192b87bf46429fa0c3e5f8d22d39b62025-02-03T07:23:36ZengWileyJournal of Nutrition and Metabolism2090-07242090-07322015-01-01201510.1155/2015/123158123158Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled TrialMarlieke Visser0Hans W. M. Niessen1Wouter E. M. Kok2Riccardo Cocchieri3Willem Wisselink4Paul A. M. van Leeuwen5Bas A. J. M. de Mol6Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, NetherlandsDepartment of Pathology and Cardiac Surgery, ICaR-VU, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, NetherlandsDepartment of Cardiology, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, NetherlandsDepartment of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, NetherlandsDepartment of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, NetherlandsDepartment of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, NetherlandsDepartment of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, NetherlandsMajor surgery induces a long fasting time and provokes an inflammatory response which increases the risk of infections. Nutrition given before and during surgery can avoid fasting and has been shown to increase the arginine/asymmetric dimetlhylarginine ratio, a marker of nitric oxide availability, in cardiac tissue and increased concentrations of branched chain amino acids in blood plasma. However, the effect of this new nutritional strategy on organ inflammatory response is unknown. Therefore, we studied the effect of nutrition before and during cardiac surgery on myocardial inflammatory response. In this trial, 32 patients were randomised between enteral, parenteral, and no nutrition supplementation (control) from 2 days before, during, up to 2 days after coronary artery bypass grafting. Both solutions included proteins or amino acids, glucose, vitamins, and minerals. Myocardial atrial tissue was sampled before and after revascularization and was analysed immunohistochemically, subdivided into cardiomyocytic, fatty, and fibrotic areas. Inflammatory cells, especially leukocytes, were present in cardiac tissue in all study groups. No significant differences were found in the myocardial inflammatory response between the enteral, parenteral, and control groups. In conclusion, nutrition given before and during surgery neither stimulates nor diminishes the myocardial inflammatory response in patients undergoing coronary artery bypass grafting. The trial was registered in Netherlands Trial Register (NTR): NTR2183.http://dx.doi.org/10.1155/2015/123158
spellingShingle Marlieke Visser
Hans W. M. Niessen
Wouter E. M. Kok
Riccardo Cocchieri
Willem Wisselink
Paul A. M. van Leeuwen
Bas A. J. M. de Mol
Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial
Journal of Nutrition and Metabolism
title Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial
title_full Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial
title_fullStr Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial
title_full_unstemmed Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial
title_short Nutrition before and during Surgery and the Inflammatory Response of the Heart: A Randomized Controlled Trial
title_sort nutrition before and during surgery and the inflammatory response of the heart a randomized controlled trial
url http://dx.doi.org/10.1155/2015/123158
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