Cited by 59Clinical Nutrition and GastroenterologyTrauma, Hemostasis, Coagulopathy, ResuscitationSepsis Diagnosis and Treatment

Postshock Intervention With High-Lipid Enteral Nutrition Reduces Inflammation and Tissue Damage

de Haan, Jacco-Juri, Lubbers, Tim, Hadfoune, M'hamed, Luyer, Misha D., Dejong, Cornelis H., Buurman, Wim A., Greve, Jan-Willem M.·2008·Annals of Surgery

Abstract

OBJECTIVE: To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage. BACKGROUND: An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors. METHODS: A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity. RESULTS: Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05). CONCLUSION: High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response.

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Crossref · 10.1097/sla.0b013e318188752c

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  • High-lipid enteral nutrition attenuates intestinal inflammation, bacterial translocation and intestinal injury following intestinal hypoperfusion with digestive disturbances.

    “In fact, high-lipid enteral nutrition has been shown to attenuate intestinal inflammation, bacterial translocation and intestinal injury following intestinal hypoperfusion with digestive disturbances [142].”

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Authors
de Haan, J.-J., Lubbers, T., Hadfoune, M., Luyer, M. D., Dejong, C. H., Buurman, W. A., & Greve, J.-W. M.
Affiliations
  • Maastricht University Medical Centre (NL)
  • Maaslandziekenhuis (NL)
Corresponding author
  • Lubbers, Tim
  • Hadfoune, M'hamed
  • Dejong, Cornelis H.
  • Buurman, Wim A.
  • Greve, Jan-Willem M.
Venue
Annals of Surgery
Published
2008-11
Volume
248
Issue
5
Pages
842-848
ISSN
0003-4932 (ISSN-L)
OpenAlex
W2091731496
Cited by
59
References
47
Citations by year
2025: 2 · 2024: 2 · 2023: 1 · 2020: 1 · 2019: 1 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 1 · 2013: 10 · 2012: 6
FWCI
6.97
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion)
  • Research Publications (Maastricht University) (submittedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
hemorrhagic shock, cholecystokinin receptors, IL-10, interferon-gamma, bacterial translocation, intestinal permeability, enterocyte damage, severe trauma, cytokine response
MeSH terms
Animals, Dietary Fats, Enteral Nutrition, Epithelial Cells, Ileum, Immunohistochemistry, Inflammation, Interferon-gamma, Male, Peroxidase, Receptors, Cholecystokinin, Shock, Hemorrhagic, Interleukin-10, Rats, Sprague-Dawley, Bacterial Translocation, Tight Junctions, Rats

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