Influence of postoperative enteral nutrition on cellular immunity. A random double-blinded placebo controlled clinical trial

The aim of this study was to discover if the cellular immunological response is different in patients receiving early postoperative enteral nutrition compared to patients who only receive water. In a random double-blind prospective trial, 30 patients received NutridrinkA (R) and 30 patients received placebo (water) through a nasoduodenal tube from the day of operation to the fourth postoperative day. Leukocyte differential count was examined preoperatively, and on the first, third, and seventh postoperative days. Subpopulations of lymphocytes were flow cytometrically analysed. IL-1ra and soluble IL-2R were investigated by use of an enzyme-linked immunosorbent assay. In the enteral nutrition group, a significantly larger number of circulating monocytes and NK-cells and a significantly larger expression of HLA-DR were found. In the nutrition group, a tendency to larger numbers of T-lymphocyte subpopulations was found. No difference in IL-1ra and soluble IL-2R was found between the groups. Early postoperative enteral nutrition has an important influence on the immediate unspecific cellular immunity and an activating effect on the specific cellular immunity compared to no food.