Major Abdominal Surgery Clinical Trial
Official title:
Immunonutrition Versus Standard Enteral Nutrition Before Major Surgery: A Single-center Double-blinded Controlled Randomized Superiority Trial
The aim of this trial is to compare preoperative Imunnonutrition with standard enteral
nutrition regarding morbidity after major abdominal surgery in patients with NRS greater 3.
The primary end point is the complication rate until 30 days after surgery.
Malnutrition affects about 20-50% of all patients in hospital [1, 2]. Major surgery further
increases postoperative malnutrition and immunity reduction. Therefore, postoperative
complication and infection rates after major surgery exceed 30% [3-6].
The nutritional risk score (NRS) [1] is based on the ESPEN (European society of parenteral
and enteral nutrition) screening guidelines and identifies patients who are likely to
benefit from nutritional support. Patients with a NRS ≥ 3 are considered severely
undernourished, or to have a certain degree of severity of disease in combination with
certain degree of malnutrition [7].
In a prospective cohort study patients with a NRS ³ 3 had significant more infectious and
overall complications after major abdominal surgery [4, 7, 8]. Several studies showed a
benefit by nutritional support on complications [3, 5, 6]. International guidelines suggest
therefore preoperative oral nutritional support for malnourished patients undergoing major
surgery [9]. However, it remains controversial whether standard enteral nutrition (SEN) or
immunonutrition (IN) is preferable [9].
IN, containing arginine, ribonucleic acid and omega-3 polyunsaturated fatty acids aims to
improve the nutritional status, immunological function and clinical outcome [5, 10].
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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