Use of fibronectin and somatomedin‐C as markers of enteral nutrition support in traumatized patients using a modified amino acid formula

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Abstract
The purpose of this study was to evaluate the use of serum fibronectin and serum somatomedin‐C as nutritional markers during enteral nutrition support (ENS) of critically ill, traumatized patients using an enteral product containing high concentrations of branched‐chain amino acids. Twelve critically injured patients received a standard enteral formula with 30 g of a 44% branched‐chain amino acid supplement added to each liter of formula. Fibronectin concentration, somatomedin‐C concentration, and nitrogen balance were measured on study days 1, 4, 7, 14, 21, 28 or until adequate oral intake began. Both fibronectin and somatomedin‐C concentrations increased significantly from baseline by day 7 of ENS. Nitrogen balance increased significantly from baseline by day 4. On days 14 and 21, only somatomedin‐C and nitrogen balance increased significantly from baseline. Nitrogen balance was significantly correlated with somatomedin‐C concentration (r = 0.53, p less than 0.01), cumulative caloric intake (r = 0.68, p less than 0.01), and cumulative nitrogen intake (r = 0.72, p less than 0.01). The results of this study suggest that serum somatomedin‐C is useful and serum fibronectin has potential in monitoring nutrition support response in critically ill, traumatized patients.