Mensah Caleb, Redko S.I.
Department of Emergency Medical Care and Disaster Medicine,
Medical Institute, Sumy State University, Ukraine
Toufik’s Medical Journal
Volume 1, Supplement 1, November 2021
Abstract from Biomedical Perspectives III
Introduction: Any severe concomitant injury leads to a decrease in the body’s immune response. Studies of the state of lymphocytes in the early post-traumatic period show a sharp decrease in the content of these cells within the first 24 hours after injury. Glutamine, as a food source for rapidly proliferating cells (enterocytes, lymphocytes and macrophages), is able to rapidly increase the lymphocyte content and thereby enhance immunity.
Aim: to study the effect of enteral nutrition enriched with glutamine on the dynamics of lymphocytes in concomitant injury
Materials and methods: The prospective study included 60 victims with concomitant trauma (severity on the APACHE II scale more than 15 points), 40 men (66%) and 20 (44%) women. The average age of the patients was 45.7 ± 10 years. The patients were divided into 2 groups. Group 1 included 30 patients who previously received enteral nutrition (EN) enriched with pharmacological nutrients – glutamine (20 g / L), the second group consisted of 30 patients who received standard early enteral nutrition. The assessment of the dynamics of the absolute lymphocytes number level in patients was carried out upon admission, then on the 1st, 3rd and 5th days of being in the ICU.
Results: At the time of admission, all victims had a high content of the absolute number of lymphocytes – 3.1 (2.8-3.5) * 10 9 / l. In the early posttraumatic period, all patients showed a sharp decrease in the absolute number of lymphocytes. However, by the end of the first day, it sharply decreases to 1.0 (0.8-1.2) * 10 9 / l. Subsequently, a reliably significant increase in the number of lymphocytes in patients of group 1 is monitored, especially on days 3 and 5.
Conclusions: 1. In all victims with severe concomitant trauma, during the first 24 hours, there is a sharp decrease in the content of the absolute lymphocytes number in the peripheral blood.
2. With the early introduction of enteral nutrition, all victims have an increase in the number of lymphocytes by the 3rd day of being in the ICU. However, with the same amount of nutrition in patients receiving standard enteral mixtures, the level of the absolute number of lymphocytes on the 3rd and 5th days of being in the ICU is lower, in contrast to patients receiving food enriched with glutamine.