Nutricion hospitalaria · 2007
[Nutritional support in patients with open abdomen].
Клиническое исследованиеАннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Velázquez J O, Urbistazu J P, Vargas M, Guedez I, Cadenas M
Аннотация
OBJECTIVE: We have designed a protocol to evaluate the tolerance, effectiveness and the nutritional support in post-surgical patients with an open abdomen.
PATIENTS AND METHODS: We have made a prospective descriptive study of patients submitted to surgery and left with an open abdomen with a Bogoti bag, and have received nutritional support. The patients who have stayed for less than 4 days with the open abdomen where excluded. A group received total parenteral nutrition (TPN) with mixtures all in one; another group received enteral nutrition (EN) through a needle catheter jejunostomy (NCJ) and a third group received mixed nutritional support. To evaluate the tolerance to EN, we have included those patients receiving this type of nutrition for at least 4 consecutive days without having diarrhea or pain. A jejunostomy catheter was placed in all patients by need o puncturing during the surgical act.
SETTING: The Surgical Department I of Angel Larralde University Hospital, I.V.S.S. Valencia-Venezuela, during the period from May 2002 to May 2005.
RESULTS: 24 patients entered the study, 46% recived mixed nutritional support (Enteral and Parenteral), 33% exclusively TPN, and 31% exclusively EN. 75% have evolved favorably, discharged to their home in good general condition; 25% died from multiple organ failure due to severe sepsis. About nutritional support, 66% of the patients did not present complications; 21% of those receiving TPN presented hyperglycemia; and 13% of those receiving EN presented diarrhea. About EN effectiveness, 69% of the patients have reached 80% of the estimated caloric objective within days 4-5 from the beginning of formula administration.
CONCLUSIONS: The integral care of the patients with an open abdomen, added to a nutritional support regimen tailored to each patient's condition can help decreasing the hypermetabolic response, as well as moridity and mortality.
PATIENTS AND METHODS: We have made a prospective descriptive study of patients submitted to surgery and left with an open abdomen with a Bogoti bag, and have received nutritional support. The patients who have stayed for less than 4 days with the open abdomen where excluded. A group received total parenteral nutrition (TPN) with mixtures all in one; another group received enteral nutrition (EN) through a needle catheter jejunostomy (NCJ) and a third group received mixed nutritional support. To evaluate the tolerance to EN, we have included those patients receiving this type of nutrition for at least 4 consecutive days without having diarrhea or pain. A jejunostomy catheter was placed in all patients by need o puncturing during the surgical act.
SETTING: The Surgical Department I of Angel Larralde University Hospital, I.V.S.S. Valencia-Venezuela, during the period from May 2002 to May 2005.
RESULTS: 24 patients entered the study, 46% recived mixed nutritional support (Enteral and Parenteral), 33% exclusively TPN, and 31% exclusively EN. 75% have evolved favorably, discharged to their home in good general condition; 25% died from multiple organ failure due to severe sepsis. About nutritional support, 66% of the patients did not present complications; 21% of those receiving TPN presented hyperglycemia; and 13% of those receiving EN presented diarrhea. About EN effectiveness, 69% of the patients have reached 80% of the estimated caloric objective within days 4-5 from the beginning of formula administration.
CONCLUSIONS: The integral care of the patients with an open abdomen, added to a nutritional support regimen tailored to each patient's condition can help decreasing the hypermetabolic response, as well as moridity and mortality.