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Effects of immunonutrition on biomarkers in traumatic brain injury patients in Malaysia: a prospective randomized controlled trial

  • Rai, Vineya Rai Hakumat1, 2
  • Phang, Lee Fern3
  • Sia, Sheau Fung4
  • Amir, Amirah5
  • Veerakumaran, Jeyaganesh S.6
  • Kassim, Mustafa Kassim Abdulazez6
  • Othman, Rafidah7
  • Tah, Pei Chien7
  • Loh, Pui San6
  • Jailani, Mohamad Irfan Othman6
  • Ong, Gracie6
  • 1 School of Medicine, Taylor’s University, Lakeside Campus, Subang Jaya, 47500, Malaysia , Subang Jaya (Malaysia)
  • 2 KPJ Tawakkal Specialist Hospital, Jalan Pahang Barat, Kuala Lumpur, 53000, Malaysia , Kuala Lumpur (Malaysia)
  • 3 Department of Anaesthesiology, Hospital Umum Sarawak, Jalan Hospital, Kuching, Sarawak, 93586, Malaysia , Kuching (Malaysia)
  • 4 University of Malaya, Division of Neurosurgery, Faculty of Medicine, Kuala Lumpur, 50603, Malaysia , Kuala Lumpur (Malaysia)
  • 5 University of Malaya, Department of Parasitology, Faculty of Medicine, Kuala Lumpur, 50603, Malaysia , Kuala Lumpur (Malaysia)
  • 6 University Malaya, Department of Anaesthesiology, Faculty of Medicine, Kuala Lumpur, 50603, Malaysia , Kuala Lumpur (Malaysia)
  • 7 University Malaya Medical Centre, Department of Dietetics, Kuala Lumpur, 50603, Malaysia , Kuala Lumpur (Malaysia)
Published Article
BMC Anesthesiology
Springer (Biomed Central Ltd.)
Publication Date
Jun 15, 2017
DOI: 10.1186/s12871-017-0369-4
Springer Nature


BackgroundHead injury is one of the top three diagnosis leading to intensive care unit (ICU) admission in Malaysia. There has been growing interest in using immunonutrition as a mode of modulating the inflammatory response to injury or infection with the aim of improving clinical outcome. The aim of the present study was to evaluate the effect of an immunonutrition on biomarkers (IL-6, glutathione, CRP, total protein and albumin) in traumatic brain injury patients.MethodsThirty six patients with head injury admitted to neurosurgical ICU in University Malaya Medical Centre were recruited for this study, over a 6-month period from July 2014 to January 2015. Patients were randomized to receive either an immunonutrition (Group A) or a standard (Group B) enteral feed. Levels of biomarkers were measured at day 1, 5 and 7 of enteral feeding.ResultsPatients in Group A showed significant reduction of IL-6 at day 5 (p < 0.001) with concurrent rise in glutathione levels (p = 0.049). Patients in Group A also demonstrated a significant increase of total protein level at the end of the study (day 7).ConclusionThese findings indicate the potential of immunonutrition reducing cytokines and increasing antioxidant indices in patients with TBI. However, further studies incorporating patient outcomes are needed to determine its overall clinical benefits.Trial registrationNational Medical Research Register (NMRR) ID: 14–1430-23,171. identifier: NCT03166449.

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