ABSTRACT
Objective:To investigate the effect of early enteral nutrition on ventilator-associated pneumonia in patients with Guillain Barre syndrome.Methods:This study was a prospective study.The study subjects were 36 patients diagnosed with Guillain Barre syndrome in the neuro-intensive care unit of our hospital from May 2011 to May 2017.Among them,18 patients received enteral nutrition support treatment within 24 hours after mechanical ventilation (early group),and 18 patients received enteral nutrition support treatment more than 24 hours after mechanical ventilation (control group).The two groups were compared with nutritional indicators,complications of enteral nutrition,ventilatorassociated pneumonia incidence,mechanical ventilation time,NICU residence time,APACHE Ⅱ score and mortality after treatment.Results:In the early group,the incidence of ventilator-associated pneumonia,mechanical ventilation time,NICU residence time and APACHE Ⅱ score after treatment were lower than the control group and the nutritional status index were better than the control group.Meanwhile,the incidence of complications of enteral nutrition such as diarrhea,gastrointestinal bleeding and stress hyperglycemia was relatively low.Moreover,the fatality rate was lower than the control group,but there was no statistical significance.Conclusions:Early application of enteral nutrition support therapy can improve the nutritional status of patients,reduce the incidence of ventilator-associated pneumonia,shorten the time of mechanical ventilation,reduce mortality and improve the prognosis of patients.
ABSTRACT
Objective To investigate the value of endoscopic assisted nasal jejunal tube placement and jejunum nutrition in treatment of critically illed patients. Methods This study was a prospective study. 56 patients with severe cerebrovascular diseases in the department of NICU from May 2014 to May 2017 were enrolled in this study. All of the patients were found to have an increased gastric remnant within 72 hours after admission (>100 ml). In the nasal jejunal group, 28 patients received nasal endoscopy and nasal endoscopic feeding, and 28 cases were treated with routine nasogastric tube and enteral nutrition. Comparing the two groups of patients with gastrointestinal complications (including vomiting, gastroesophageal reflux, abdominal distension, diarrhea, stress ulcer incidence) and nutritional status parameters (including serum albumin, prealbumin, hemoglobin), incidence of hospital acquired pneumonia and inflammation indexes (including WBC, PCT and CRP), stay at NICU time, NICU expenses, GCS score and mortality rate. Results The success rate of nasal intestinal tube placement under nasal endoscopy guided wire was 100.0%. The nasal jejunal nutrition status parameters were better, NICU check-in time was shorter, NICU expenses were lower, and the inflammation index was lower than the control group. There were no significant differences in the incidence of gastrointestinal complications, the incidence of hospital acquired pneumonia, the GCS score and the fatality rate between the two groups. Conclusion For the patients with severe gastric remnant increase in NICU, it is worth recommending that naso jejunal tube be inserted into the jejunum by endoscopy and using jejunum nutrition.