Elderly patients and those with poor ventricular function have increased illness and death rates when undergoing cardiac surgery.
Robert Tepaske and colleagues from the University of Amsterdam, Netherlands, assessed whether an oral "immune-enhancing nutritional supplement" could improve patients' preoperative immune defense. They also tested whether it could subsequently lower rates of postoperative infections and organ dysfunction in patients undergoing elective cardiac surgery.
| Benefits of nutritional supplement:|
- Improved preoperative host defense
- Reduced postoperative infections
- Preserved renal function
In a prospective, randomized study, 50 patients were given either the nutritional supplement (containing L-arginine, 3 polyunsaturated fatty acids, and yeast RNA) or placebo for a minimum of 5 days before coronary artery bypass.
Patients were included if they were aged 70 years or older, or if they had a left-ventricular ejection fraction of less than 0.4, or were scheduled to undergo mitral-valve replacement.
Patients given the nutritional supplement had improved preoperative host defense, and fewer patients had postoperative infections (4 patients compared with 12 in the control group). In addition, they had better preserved renal function compared with patients given placebo.
The investigators conclude that their study supports the use of an oral immune-enhancing nutritional supplement in patients who are undergoing cardiac surgery and are at high risk of infection.