Author Year

Country

Research Design

PEDro

Sample Size

Methods

Outcomes

Sacks et al. (1995)

USA

RCT

Population: Head injury; Early Group (n=4): Mean Age=39.3 yr; Gender: Male=4, Female=0; Mean GCS Score=8. Delayed Group (n=5): Mean Age=35.2 yr; Gender: Male=4, Female=1; Mean GCS Score=7.

Intervention: Patients were randomly allocated to receive either early Parenteral Nutrition (PN) at day 1 or delayed PN at day 5. All patients received PN through a central venous catheter with a nutrient goal of 2 g protein/kg/d & 40 non-protein kcal/kg/day for at least the initial 14 days of hospitalization. Assessments were made on entry, and days 3, 7, and 14.

Outcome Measures: Cell counts of T-lymphocytes with expression of CD4 and CD8 antigens, lymphocyte response following Con A stimulation.

1.        From baseline to day 14, there was a significant increase in the total CD4 cell count (p<0.05) and in CD4 (%) (p<0.001) in the early PN group, while remaining relatively stable in the delayed PN group. Differences in total CD4 cell count and in CD4 (%) at day 14 was significant between the groups as well (p<0.05).

2.        The CD4-CD8 ratio significantly increased from baseline to day 14 in the early PN group (p<0.05), but not in the delayed PN group. The difference between groups, however, was not significant.

3.        From baseline to day 14, following Con A stimulation, an improved lymphocyte response was demonstrated in the early PN group (p<0.05), but not in the delayed PN group.