Feasibility of jejunal enteral nutrition for patients with severe duodenal injuries
| Autor: | George O. Maish, Gayle Minard, Thomas J. Schroeppel, Johnathan Voss, Roland N. Dickerson, Martin A. Croce, Louis J. Magnotti |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Parenteral Nutrition Abdominal pain medicine.medical_specialty Adolescent Duodenum Critical Illness Endocrinology Diabetes and Metabolism medicine.medical_treatment Jejunostomy Distension Enteral administration Body Mass Index Young Adult 03 medical and health sciences Enteral Nutrition Blunt medicine Humans Feeding tube Retrospective Studies 030109 nutrition & dietetics Nutrition and Dietetics business.industry Abdominal distension Surgery Hospitalization Intensive Care Units Treatment Outcome Parenteral nutrition Feasibility Studies Wounds and Injuries Female medicine.symptom Energy Intake business |
| Zdroj: | Nutrition. 32:309-314 |
| ISSN: | 0899-9007 |
| Popis: | Objective: The aim of this study was to evaluate the feasibility of enteral nutrition (EN) for critically ill trauma patients with severe traumatic duodenal injuries who received placement of concurrent decompressing and feeding jejunostomies. Methods: Adult patients admitted to the trauma intensive care unit from January 2010 to December 2013, given concurrent afferent decompressing and efferent feeding jejunostomies for severe duodenal injury and provided EN or parenteral nutrition (PN), were retrospectively evaluated. Enteral feeding intolerance was defined as an increase in the decompressing jejunostomy drainage volume output, worsening abdominal distension, or cramping/pain unrelated to surgical incisions. Patients who failed initial EN were transitioned to PN. Results: Twenty-six patients were enrolled. Of the 24 patients given EN within the first 2 wk posthospitalization, 18 (75%) failed EN within 2 � 2 d of initiating EN. EN was discontinued when increases were seen in decompressing jejunostomy drainage volume output (n ¼ 11) and output with abdominal pain and/or distension (n ¼ 6), or abdominal pain/distension was seen without an increase in output (n ¼ 1). Jejunostomy drainage volume output increased from 474 � 425 mL/d to 1168 � 725 mL/d (P < 0.001) during EN intolerance. More patients with blunt intestinal injury than those with penetrating injuries (75% versus 15%, respectively; P ¼ 0.035) tolerated EN. Patients initially given PN (n ¼ 13) received more calories (P < 0.005) and protein (P < 0.001) than those given initial EN (n ¼ 13). Conclusion: The majority of patients with severe duodenal injuries and concurrent decompressing/ feeding tube jejunostomies failed initial EN therapy. |
| Databáze: | OpenAIRE |
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