Parenteral and enteral nutrition and the enterocutaneous fistula treatment. I. Investigations on fistula output, nutritional status complications
| Autor: | E, Dárdai, S, Pirityi, L, Nagy |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
Gastric Fistula Male Parenteral Nutrition Fistula Ileal Diseases Nitrogen Nutritional Status Bacterial Infections Blood Proteins Middle Aged Dietary Fats Skin Diseases Enteral Nutrition Postoperative Complications Intestine Small Dietary Carbohydrates Intestinal Fistula Equipment Contamination Humans Female Prospective Studies Amino Acids Serum Albumin Aged |
| Zdroj: | Acta chirurgica Hungarica. 32(4) |
| ISSN: | 0231-4614 |
| Popis: | Prospective evaluation were made of 45 patients with postoperative small bowel fistulas treated with total parenteral nutrition (TPN) and enteral nutrition (EN) between 1971-1988. The administration of TPN in the early treatment of enteric fistulas decreased the mean fistula output significantly (p0.05-0.001) and provided an effective tool in the control of high-output fistulas. The electrolyte contents of different fistula secretions were unchanged and the losses through the fistulas depended on the daily output. In patients with high-output fistulas acid-base balance disturbances had to be corrected. When comparing two parenteral nutrition regimens (carbohydrate+amino acids /CH + AA/ versus carbohydrate + amino acids + fat /CH + AA + F/) both facilitated the reduction of fistula secretion (in high-output fistulas. CH + AA = -50.2%; CH + AA + F = -49%). Positive nitrogen balance was achieved in non septic patients after 13 days of treatment. Improvement of serum protein and albumin occurred by the time of fistula healing. In non surviving patients significant decrease in protein synthesis was observed. Out 7 of 75 central venous catheters yielded positive bacterial cultures (9.3%). In 5 patients autopsy proved generalized sepsis. The use of parenteral and enteral nutrition proved to be a powerful method for controlling the enterocutaneous fistulas and maintaining the nutritional integrity of patients. |
| Databáze: | OpenAIRE |
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