Early Postoperative Nutritional Support Using the Serosal Tunnel Jejunostomy
| Autor: | Robert B. Gilsdorf, L. Mason Cobb, Andrea M. Cartmill |
|---|---|
| Rok vydání: | 1981 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal Diseases 030309 nutrition & dietetics medicine.medical_treatment Serum albumin Medicine (miscellaneous) 03 medical and health sciences Enteral Nutrition Serous Membrane 0302 clinical medicine Intravenous fluid medicine Humans Medical nutrition therapy Serum Albumin Postoperative Care 0303 health sciences Nutrition and Dietetics biology business.industry Albumin Nutrition Disorders Surgery Jejunum Parenteral nutrition Jejunostomy biology.protein 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Parenteral and Enteral Nutrition. 5:397-401 |
| ISSN: | 1941-2444 0148-6071 |
| DOI: | 10.1177/0148607181005005397 |
| Popis: | A silicone rubber serosal tunnel jejunostomy for postoperative nutritional therapy was placed in 38 patients who had major operations. A dilute, chemically defined diet was begun within 48 hours of surgery and an attempt made to advance it slowly to full strength by the fifth day. No catheter-related complications occurred. Intravenous fluid therapy was shortened to less than three days in 11 (29%) patients. Only 17 (45%) patients tolerated full-strength feedings within the protocol time. Three (8%) patients depended on their tube feedings for over 30 days and the need for parenteral nutrition was avoided. Of six septic patients, four had complete intolerance of the diet; two of these developed massive gastric hypersecretion. Serum albumin was a statistically significant indicator of whether a patient could tolerate tube feedings. No patient with an albumin less than 3 g/dl tolerated full-strength feedings and the pded. Of six septic patients, four had complete intolerance of the diet; two of these developed massive gastric hypersecretion. Serum albumin was a statistically significant indicator of whether a patient could tolerate tube feedings. No patient with an albumin less than 3 g/dl tolerated full-strength feedings and the patients with albumin greater than 4 g/dl had no problems. Postoperative feeding utilizing the serosal tunnel jejunostomy is technically safe, but feeding difficulties can be anticipated in those patients who are septic or severely malnourished; these are the patients whose nutritional needs are the greatest. The greatest benefits accrue to those patients who are in need of long-term nutritional support. We recommend routine placement of these catheters in major operations. |
| Databáze: | OpenAIRE |
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