A randomized study of an evaluation of Trigona honey as immunonutrition among ventilated pneumonia patients in intensive care unit

Abstract

Background & Objective: Honey is one of the traditional drugs and has been widely used as a nutrient supplement for centuries. It is known to have antimicrobial, antioxidant and radical scavenging properties. We aimed to prove that natural honey can be added as a supplementary nutrient for its immunoprotective effects to the ventilated pneumonia patients in intensive care unit (ICU). Methodology: A total of 40 ventilated pneumonia patients were randomized to receive enteral feeding with honey (n = 20) or without honey (n = 20). A bolus of 20 g of honey was given every day for 5 days together with normal enteral nutrition. The baseline vital signs, ventilator settings, blood samples for C-reactive protein (CRP), white blood cell (WBC), interleukin-6 (IL-6), interleukin-10 (IL-10), immunoglobulin A (IgA) and blood sugar level were taken on the day of recruitment (Day 0) and subsequently on Day 3 and Day 6. Results: There were significant changes in IL-6 level over time in honey group with mean decrease of IL-6 from 265.1 pg/ml on Day 0 to 101.8 pg/ml on Day 6 (P < 0.001). There was no significant effect on CRP (P = 0.22), IL-10 (P = 0.548), IgA (P = 0.197), WBC count (P = 0.640) and blood sugar level between both groups (P > 0.05). Duration of antibiotic use between the two groups showed no statistically significant difference with P = 0.075 and length of ICU stay. Conclusion: Trigona honey showed the beneficial effect of immunonutrition to ventilated pneumonia patients in ICU by significantly decreasing the level of IL-6. Abbreviations: CAP: community acquired pneumonia; CRP: C-reactive protein; DHA: docosahexaenoic acid; HAC: hospital acquired pneumonia; ICU: intensive care unit; IL-6: interleukin-6; Ig-A: immunoglobulin A; NGT: Nasogastric tube; RBS: random blood sugar; VAP: ventilator associated pneumonia Citation: Zaini RHM, Omar SC, Binti Ismail IS, Wan Hassan WMN, Seevaunnamtum P, Che Hussin CM. A randomized study of an evaluation of Trigona honey as immunonutrition among ventilated pneumonia patients in intensive care unit. Anaesth. pain intensive care 2022;26(5):649-655; DOI: 10.35975/apic.v26i5.1990