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Yayınlar
- MakaleAçık Erişim2026Scopus SJRQ1Effect of Perioperative Supplementation with Arginine and Omega-3 on Postoperative Complications in Patients Undergoing Gastrointestinal Cancer Surgery: A Pilot Open-Label Randomized Controlled Trial
Sakhri, Saida; Othman, Rym Ben; Jerbi, Chaima; Ceylan, Halil Ibrahim; Naija, Lamia; Zemni, Ines; Jamoussi, Henda; Dhiab, Tarek Ben; Ceylan, Nagihan Burcak; Stefanica, Valentina
Background: Perioperative immunonutrition, including arginine and omega-3 fatty acids, has been proposed to support postoperative recovery by modulating immune function. Aim: To evaluate the effects of perioperative arginine and omega-3 supplementation on postoperative infectious complications, mortality, hospital length of stay, intensive care unit duration, and inflammatory markers in patients undergoing gastrointestinal cancer surgery. Methods: In this Pilot Open-Label randomized trial, 35 adult patients scheduled for elective gastrointestinal cancer surgery at Salah Azaiez Institute were randomly assigned to receive either perioperative immunonutrition (n = 18; three daily capsules of omega-3 and one sachet of Arginine+ for 7 days preoperatively and 7 days postoperatively) or standard care (n = 17). Primary endpoints were postoperative infectious complications and 1-month mortality. Secondary endpoints included hospital length of stay, ICU duration, and postoperative biochemical markers. Results: No statistically significant differences were observed between groups in 1-month mortality (p = 0.324), hospital length of stay (median 7 vs. 7 days, p = 0.392), or ICU duration (median 5 vs. 6 days, p = 0.601). Urinary tract infection (5.9% vs. 11.1%, p = 0.939) and wound infection rates (5.9% vs. 11.1%, p = 0.581) were comparable. Importantly, postoperative C-reactive protein and other inflammatory markers did not differ significantly between groups (CRP: 165 vs. 175 mg/L; intergroup p = 0.798). Conclusions: In this trial, perioperative immunonutrition with arginine and omega-3 fatty acids did not improve postoperative clinical outcomes or inflammatory markers in patients undergoing gastrointestinal cancer surgery. At the administered dose and within a small, heterogeneous cohort, immunonutrition did not provide additional benefit beyond standard care. Larger, adequately powered multicenter trials with optimized dosing are required to clarify its role in gastrointestinal oncology.
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İncele - MakaleAçık Erişim2026Scopus SJRQ1High Prevalence of Malnutrition and Sarcopenia with Inadequate Nutritional Support in Intensive Care Unit Patients: A Prospective Observational Study of Clinical Outcomes
Ben Othman, Rym; Cherni, Asma; Dergaa, Ismail; Ceylan, Halil Ibrahim; Ceylan, Nagihan Burcak; Stefanica, Valentina; Sedghiani, Ines; Borsali, Nebiha; Jamoussi, Henda
Background: Malnutrition and sarcopenia are highly prevalent in intensive care settings and are associated with adverse clinical outcomes. Aim: The study aimed to evaluate the association between nutritional care, nutritional status, and patient outcomes in intensive care units. Methods: This prospective observational study at a Tunisian tertiary hospital investigated nutritional status and management of 100 intensive care unit patients, each of whom was followed for seven days after ICU admission. Malnutrition Risk was assessed by NUTRIC and MNA scores. The severity of disease was assessed using the APACHE II and SOFA scores. Malnutrition was diagnosed using body mass index and weight loss. Sarcopenia was assessed through grip strength, calf circumference, and psoas muscle area. Nutritional management was evaluated using calculations of caloric and protein intake. Clinical outcomes included the need for intubation, difficulty with oxygen weaning, healthcare-associated infections, and the development of pressure ulcers. Results: The participants had a mean age of 54.85 +/- 17.25 years, with a slight male predominance (53 males, 47 females). Pre-existing metabolic conditions affected 80% of patients, including hypertension (40 patients), diabetes (36), and obesity (18). The primary reasons for admission were respiratory disorders (25%), infectious diseases (23%), and metabolic disorders (16%). The mean APACHE II score was 15.91 +/- 6.84, and the mean NUTRIC score was 3 +/- 1.66; 27% were classified as at high risk of malnutrition. The prevalence of malnutrition reached 50% (28% moderate, 22% severe). Only 31% received adequate caloric intake, while 84% had insufficient protein intake. Malnourished patients required intubation more frequently (50% versus 22.5%; p = 0.014), experienced greater difficulty with oxygen weaning (78.4% versus 48.6%; p = 0.008), and developed pressure ulcers more often (43.5% versus 6%; p < 0.001). Sarcopenic patients showed similar patterns for intubation (51.4% versus 18.9%, p = 0.003), oxygen weaning difficulty (77.5% versus 46.9%, p = 0.007), and pressure ulcers (39.2% versus 6.7%, p < 0.001). Conclusions: Malnutrition and sarcopenia are highly prevalent in intensive care patients and are associated with severe complications, including prolonged mechanical ventilation and pressure ulcer development. Inadequate nutritional support remains common despite known consequences. Early comprehensive nutritional assessment and appropriate management from admission are essential to improve outcomes in critically ill patients.
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