Pré-condicionamento com l-alanil-glutamina, l-arginina e ômegas 3, 6 e 9 sobre as proteínas de choque térmico e marcadores inflamatórios em pacientes submetidas à abdominoplastia total

• Ano de defesa: 2014
• Autor(a) principal: Cavalcante, Mara Cinthia Coelho
• Orientador(a): Vasconcelos, Paulo Roberto Leitão de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Palavras-chave em Português: Abdominoplastia; Inflamação; Ácidos Graxos
• Link de acesso: http://www.repositorio.ufc.br/handle/riufc/13582

Abdominoplasty is a lower abdominal lipectomy combined with muscle fascia repair by plication of the aponeuroses of the rectus abdominis muscle. The procedure is traumatic and associated with stress-related inflammation. Preoperative administration of nutraceuticals is believed to reduce postoperative complications such as inflammation and improve surgical results. Once a day for 7 days prior to surgery, patients were supplemented with two diets: SNO1 (negative control) or SNO2. The former was a dairy drink containing 0% fat, 64% carbohydrate (100% maltodextrin) and 36% protein (100% calcium caseinate), corresponding to 37.4 kcal/100mL. The latter was a dairy drink containing 14% carbohydrate (25% maltodextrin, 75% fructose), 25% protein (60% L-alanyl-glutamine, 40% L-arginine) and 61% lipids in the form of a mixture of oleic acid-rich sunflower oil, canola oil, fish oil and medium-chain triglycerides containing ω-9, ω-6 and ω-3 fatty acids, the latter with α-linolenic acid, eicosapetaenoic acid and docosahexaenoic acid, with a ω-9/ω-6 ratio of 3.2:1 (antioxidant action) and a ω-6/ω-3 ratio of 1.4:1 (anti-inflammatory action), corresponding to 200 kcal/100mL. Each patient ingested 200mL SNO1 or SNO2 blended with 50 g diet ice-cream. The sample consisted of 25 adult patients randomly assigned to SNO1 (n=11) or SNO2 (n=14) and submitted to total abdominoplasty. The study variables included HSP-27, HSP-70, IL-1β, IL-6, PCR and TNF-α. Clinical and lab tests were performed on four occasions: T0=on the 1st day of supplementation following a 12-hour fast; T1=on the 8th day, upon induction of anesthesia, after confirming ingestion of study diet for 7 consecutive days; T2=on the 9th day (POD 1), 24 hours after surgery; and T3=on the 11th day (POD 3), 72 hours after surgery. No significant difference was observed between the groups at any of the four moments in time. In conclusion, oral nutraceutical supplementation with L-alanyl-glutamine, arginine and mixtures of oils with high ω-9/ω-6 ratio and low ω-6/ω-3 ratio has no significant preconditioning effect on inflammatory mediators in surgical trauma