Was infused continuously in three stepwise increased doses (0.6, 1.2 and 1.8 ol/kg/min), each dose for 2 hours. Haemodynamics were recorded at 30-min intervals. Plasma arginine levels were analysed by HPLC. Repeated-measurements ANOVA was used to compare doses; data are means ?SEM. Results No significant changes in systemic blood pressure were observed. Compared with plasma ARG levels of age-matched healthy subjects (81 ?5 ), levels were reduced in our patients (P < 0.05). The heart rate decreased during ARG supplementation and the stroke volume increased (Table 1).Table 1 (abstract P208) Baseline Plasma arginine ( ) MAP (mmHg) HR (beats/min) Stroke volume (ml/beat) 49 ?2 75 ?7 101 ?6 78 ?3 0.6 86 ?5 80 ?6 101 ?7 81 ?3 1.2 1.8 PP207 Immunonutrition with eicosapentaenoic acid and -linolenic acid as a new strategy to reduce mortality and improve outcomes in patients with severe sepsis1FernandesA Pontes-Arruda1, A Aragao2, J Albuquerque2 Tavora Hospital, Fortaleza, Brazil; 2Ant io Prudente Hospital, Fortaleza, Brazil Critical Care 2006, 10(Suppl 1):P207 (doi: 10.1186/cc4554)Introduction Enteral diets enriched with EPA (fish oil), GLA (borage oil) and elevated levels of antioxidant vitamins are capable of ameliorating several outcomes in patients with ARDS. Several studies using animal models of sepsis point towards a possible role of enteral nutrition enriched with omega-3 fatty acids in the reduction of mortality. Hypothesis This study investigates whether an enteral diet enriched with EPA, GLA and elevated levels of antioxidants can improve outcomes and reduce 28-day all-cause mortality in patients with severe sepsis or septic shock under mechanical ventilation. Methods This is a prospective, double-blind, placebo-controlled, randomized trial. One hundred and sixty-five patients with either severe sepsis or septic shock were enrolled. Patients were randomized and continuously tube-fed either EPA, GLA and elevated antioxidants or a control diet isonitrogenous and isocaloric to the study diet and PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/27509597 delivered to achieve a minimum of 75 of basal energy expenditure PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/21804710 ?1.3 during a minimum of 4 days. Results Septic patients fed EPA, Gemigliptin GLA and elevated antioxidants showed a significant reduction in mortality rate, with an absolute reduction of 19.4 (P = 0.037). The EPA+GLA-fed group also presented significant improvements in oxygenation status from baseline to study days 4 and 7, more ventilator-free days (13.4 vs 5.8, P < 0.001), more ICU-free days (10.8 vs 4.6, P < 0.001) and significantly less development of new organ dysfunctions during the follow-up period (P < 0.001). Conclusions An enteral formulation enriched with EPA, GLA and elevated antioxidants can contribute to better ICU and hospital outcomes, and is also associated with lower mortality rates of136 ?7 192 ?9 <0.01 79 ?4 80 ?4 96 ?6 95 ?6 <0.05 83 ?5 88 ?4 <0.Conclusions ARG infusion does not affect systemic and pulmonary blood pressure, but increases the cardiac stroke volume. This indicates that continuous ARG supplementation does not deteriorate the haemodynamic condition in severe septic patients, despite its vasodilating effect. Acknowledgement Supported by Novartis.P209 Cellular immunity changes after total parenteral nutrition enriched with glutamine in patients with systemic inflammatory response syndromeF Cetinbas, B Yelken, Z Gulbas Osmangazi University Medical School, Eskisehir, Turkey Critical Care 2006, 10(Suppl 1):P209 (doi: 10.1186/cc4556) The immune status is altered.
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