Timing of Parenteral Feeding

Author/Year/ Country/Study design/PEDro Score/ N

 

Methods

 

Outcomes

Sacks et al. (1995)
USA
RCT
PEDro=5
N=9

 

Population: Head injury; Early Group (n=4): Mean Age=39.3yr; Gender: Male=4, Female=0; Mean GCS Score=8. Delayed Group (n=5): Mean Age=35.2yr; Gender: Male=4, Female=1; Mean GCS Score=7.
Treatment: Patients were randomly allocated to receive either early parenteral nutrition (PN) at day 1 or delayed PN at day 5. All patients received PN through a central venous catheter with a nutrient goal of 2g protein/kg/d & 40 non-protein kcal/kg/day for at least the initial 14d of hospitalization. Assessments were made on entry, and days 3, 7, and 14.
Outcome Measure: Cell counts of T-lymphocytes with expression of CD4 and CD8 antigens, lymphocyte response following Con A stimulation.

  1. From baseline to day 14, there was a significant increase in the total CD4 cell count (p<0.05) and in CD4 (%) (p<0.001) in the early PN group, while remaining relatively stable in the delayed PN group. Differences in total CD4 cell count and in CD4 (%) at day 14 was significant between the groups as well (p<0.05).
  2. The CD4-CD8 ratio significantly increased from baseline to day 14 in the early PN group (p<0.05), but not in the delayed PN group. The difference between groups, however, was not significant.
  3. From baseline to day 14, following Con A stimulation, an improved lymphocyte response was demonstrated in the early PN group (p<0.05), but not in the delayed PN group.

PEDro = Physiotherapy Evidence Database rating scale score (Moseley et al., 2002).