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Nutritional Supplement Improves Outcome of Heart Surgery
By Alan R. Gaby, MD

Healthnotes Newswire — Taking a nutritional supplement for five days prior to open-heart surgery can improve the outcome of surgery, according to a report published in the September 1, 2001, issue of the British journal Lancet. This study has important implications because of the seriousness of the problems associated with heart surgery. While all major surgical procedures can have complications, heart surgery is particularly risky, since it involves cooling and temporarily stopping the heart while the operation is being performed. Complications of heart surgery, which include heart attack, serious infections, kidney damage, and death, are most likely to occur in elderly individuals, patients with weak hearts, and those undergoing certain heart valve-replacement procedures.

Previous studies have shown that supplementation with specific nutrients (L-arginine, omega-3 fatty acids, and ribonucleic acid [RNA] from yeast) can improve immune-system function in patients undergoing surgery. Therefore researchers were interested in determining whether enhancement of immune function might reduce the risk of postoperative infection, as well as other problems associated with heart surgery. To test that possibility, 50 high-risk patients scheduled to undergo heart surgery were randomly assigned to receive a standard liquid nutritional formula (control group) or a similar formula that contained additional L-arginine, omega-3 fatty acids, and yeast RNA (Oral Impact®; Novartis Nutrition, Bern, Switzerland). All patients consumed at least 5 liters (providing approximately 5,000 calories) and a maximum of 10 liters of the assigned formula during the five to ten days before the operation. The respective supplements were continued after surgery, as needed, until the patients were able to eat regular food.

Compared with the control group, the group receiving the fortified supplement (treatment group) demonstrated significant improvements in various measures of immune-system function. This improvement was reflected in a significantly lower proportion of patients developing postoperative infections (17% vs. 55%). In addition, the treatment group had significantly better kidney function following surgery than did the control group. The median length of stay in the hospital was 21% less in the treatment group than in the control group (7.5 vs. 9.5 days), although this difference was not statistically significant. Both nutritional supplements were well tolerated and neither caused any significant side effects.

This study shows that supplementing with a nutritional formula that contains L-arginine, omega-3 fatty acids, and yeast RNA can reduce the complications of heart surgery in high-risk patients. Although the supplement used in this study costs considerably more than standard nutritional formulas (approximately $22 per liter vs. $2 per liter),1 using this type of formula would presumably reduce the overall cost of postoperative care, considering the lower incidence of infections and other problems.

References
1. The cost-effectiveness of using Oral Impact® is discussed at the following Web site: http://www.novartismedicalnutrition.com/impact/pdfs/EconomicModel.pdf (Note: The information is presented by Novartis, the manufacturer of Oral Impact®.)

Alan R. Gaby, MD, an expert in nutritional therapies, served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the Medical Editor for Clinical Essentials Alert, is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). Currently he is the Endowed Professor of Nutrition at Bastyr University of Natural Health Sciences, Kenmore, WA.




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