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Impact Oral Description Treatment to support the effectiveness of the immune response in patients able to take an oral product. The formulation is enriched with immunomodulators (RNA, arginine, omega-3 fatty acids) and added with soluble fiber (PHGG). It is based on cutting-edge technology, as well as experience and clinical research conducted on various groups of surgical patients. As a preoperative treatment, it is effective in reducing the incidence of complications and improving patient outcomes. The treatment has reduced the incidence of postoperative infectious complications and shortened hospital stays in treated patients compared to controls. - Preoperative treatment in case of major surgery: abdominal surgery, ENT surgery, cardiac surgery; - Postoperative immunonutrition in malnourished surgical patients; - Pre- and postoperative immuno-nutritional treatment in oncological surgery; - Pre- and postoperative immuno-nutritional treatment as part of the ERAS approach; - For oral nutrition in critically ill patients with immunosuppression, in which the primary objective is to support or enhance the effectiveness of the immune response, for example: oncology patients undergoing radiotherapy or chemotherapy; patients with pressure ulcers. Property Arginine : is a semi-essential amino acid, essential for T lymphocytes growth and replication; it promotes anabolism, nitrogen retention, and wound healing; it promotes an optimal immune response in situations of metabolic stress. Marine oil : provides series 3 fatty acids: linolenic acid, and its derivatives EPA and DHA, important for containing inflammatory processes and inhibiting the immunosuppressant action of series 6 fatty acids; Impact contains a 6/3 <1 ratio, ideal for critically ill patients. Nucleotides : These are essential substrates for cells, especially those with rapid turnover, such as mucosal cells, lymphocytes, and macrophages. In non-stressful conditions, the daily requirement is met by normal endogenous synthesis or dietary intake. In cases of metabolic stress, an additional supply of nucleotides is necessary to promote adequate proliferation of T lymphocytes. Ingredients Water, sucrose, milk protein (contains lactose), maltodextrin, L-arginine, partially hydrolyzed guar gum, fish oil, mineral salts (potassium citrate, sodium citrate, calcium phosphate, sodium chloride, magnesium chloride, potassium chloride, magnesium phosphate, calcium citrate, ferrous phosphate, zinc sulfate, copper gluconate, manganese sulfate, sodium fluoride, potassium iodide, sodium molybdate, sodium selenite, chromium chloride), medium chain triglycerides, corn oil; acidifier: citric acid; emulsifiers: E471, soy lecithin; Yeast extract rich in nucleotides (RNA), choline bitartrate, flavorings, vitamins (C, niacin, pantothenic acid, E, B6, A, thiamine, riboflavin, D, K, folic acid, B12, biotin); stabilizers: E460, carrageenan, E466; antioxidant: tocopherol-rich extract; coloring: beta-carotene. Nutritional characteristics Average valuesper 100 mlfor 237 ml Energy 144 kcal 606 kJ 341 kcal 1,436 kJ Proteins 7.6 g 18 g L-arginine 1.8 g 4.3 g RNA 0.18 g 0.43 g Lipids 3.9 g 9.2 g - saturated fatty acids, of which: 1.8 g 4.3 g - MCT 1.1 g 2.6 g - monounsaturated fatty acids 0.7 g 1.7 g - polyunsaturated fatty acids 1.3 g 3.1 g - omega-3 fatty acids 0.6 g 1.42 g - EPA + DHA 0.5 g 1.2 g Carbohydrates 18.9 g 44.8 g - maltodextrins 7.8 g 18.4 g - sucrose 11.1 g 26.3 g - lactose <0.1 g - Soluble fiber (PHGG) 1.4 g 3.3 g Waterfall 76 ml 182 ml Sodium 150 mg 355 mg Chlorine 169 mg 401 mg Potassium 190 mg 450 mg Soccer 114 mg 270 mg Phosphorus 101 mg 239 mg Magnesium 32 mg 76 mg Iron 1.7 mg 4 mg Zinc 2.1 mg 5 mg Copper 250 mcg 590 mcg Iodine 21 mcg 50 mcg Selenium 6.6 mcg 15.6 mcg Manganese 0.3 mg 0.71 mg Chrome 14 mcg 33 mcg Molybdenum 22.5 mcg 53.3 mcg Fluorine 0.21 mg 0.5 mg Vitamin A 139 mcg 329 mcg Vitamin D 0.94 mcg 2.2 mcg Vitamin E 4.2 mg 10 mg Vitamin K 9.4 mcg 22.3 mcg Vitamin C 30 mg 71 mg Vitamin B1 0.17 mg 0.4 mg Vitamin B2 0.25 mg 0.6 mg Vitamin B6 0.21 mg 0.5 mg Niacin 2.2 mg 5.2 mg Folic acid 28 mcg 66 mcg Vitamin B12 0.8 mcg 1.9 mcg Pantothenic acid 1.1 mg 2.6 mg Biotin 10.1 mcg 24 mcg Choline 38 mg 90 mg Osmolarity: 680 mOsm/l Osmolality: 890 mOsm/kg H 2 O Viscosity: 50 cP (at 20°C) pH: 6.8 Omega-3/omega-6 ratio: 0.9 Aminoacidogram Amino acids per 100 g Isoleucine 4.10 Leucine 7.12 Lysine 5.83 Methionine 2.09 Cysteine 0.29 Phenylalanine 3.81 Tyrosine 4.10 Threonine 3.24 Tryptophan 1.01 Valine 5.18 Arginine 24.73 Histidine 2.23 Alanine 2.16 Aspartic acid 5.18 Glutamic acid 15.69 Glycine 1.37 Proline 7.41 Serina 4.46 How to use The standard daily dose is 3 bricks per day, or as prescribed by your doctor. Warnings Check the integrity of the container and the expiration date. Observe hygiene rules when handling. Shake well before use. To best appreciate the flavor, serve chilled. Format Impact Oral is available in a practical tripack, containing 3 237 ml bricks, corresponding to the daily dosage of preoperative immuno-nutritional therapy. Cod. 12172175 Bibliography 1. McClave, S. et al. JPEN 2009; 33: 277-316. 2. Zhu X et al. Ann Surg. 2014 Jan; 259(1):171-8. 3. Kinsella JE et al. Nutrition 1990; 6 (1): 24-25. 4. Koller M et al. Clin. Nutr. 2003; 22:59. 5. Drover JW et al. Am Coll Surg. 2011 Mar; 212(3): 385-99.e1
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