Impact of Preoperative Immunonutritional Support in Patients Undergoing Elective Thoracic Surgery.

ABSTRACT

INTRODUCTION: Several immunonutritional supplements have recently been developed. However, improvements in preoperative immunonutritional conditions using these supplements have not been analyzed in patients undergoing thoracic surgery. METHODS: This prospective, single-arm, single-institution pilot study involved patients planning to undergo thoracic surgery. Forty adults with a poor preoperative immunonutritional status were enrolled. The patients freely selected one of three oral immunonutritional supplements (IMPACTⓇ, MEINⓇ, or AboundⓇ) and started taking it on an outpatient basis from 7 to 14 days before thoracic surgery. The primary endpoint was the rate of improvement in three immunonutritional parameters on the hospitalization day body mass index (BMI), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI). These improvement rates were compared with those of a matched historical control group. RESULTS: The PNI and GNRI improvement rates were significantly higher in the immunonutritional support group than in the control group (PNI 103.1% ± 0.6% vs. 98.9% ± 1.3%, p = 0.0391; GNRI 101.7% ± 0.8% vs. 99.3% ± 0.8%, p = 0.0266), although there was no significant difference in the BMI improvement rate (101.0% ± 0.6% vs. 100.2% ± 0.7%, p = 0.3626). The PNI and GNRI improvement rates were significantly higher in the IMPACTⓇ support group than in the control group (PNI 104.5% ± 2.4% vs. 98.9% ± 1.3%, p = 0.0212; GNRI 101.6% ± 1.1% vs. 99.3% ± 0.8%, p = 0.0415). CONCLUSIONS: The present study revealed that short-term preoperative immunonutritional support can actually improve immunonutritional parameters immediately before surgery. In particular, preoperative immunonutritional support using IMPACTⓇ supplementation might be the most promising agent in patients with a poor immunonutritional condition undergoing elective thoracic surgery. TRIAL REGISTRATION University Hospital Medical Information Network 000035851.