ABSTRACT
Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.
ABSTRACT
Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.
ABSTRACT
PURPOSE: To investigate the effect of early enteral trophic feeding within 24 hours after birth compared with being started within 7 days after birth in extremely low birth weight infants (ELBWIs). METHODS: We retrospectively analyzed the medical records of all ELBWIs with gestational age of 26 weeks and less, and birth weight below 1,000 g, admitted within 24 hours after birth to neonatal intensive care unit of Samsung Medical Center from January 2000 to June 2006 who were alive at the time of discharge. Data for nutritional status and morbidities were compared between Era 1 (n=76), in which early enteral trophic feeding was started within 7 days after birth and Era 2 (n=46), started within 24 hours after birth. RESULTS: Compared to era 1, despite that gestational age and enteral feeding strarting time of ELBWIs was significantly earlier (25(+4)+/-0(+6) vs. 24(+6)+/-1(+5) weeks, 4.5+/-5.1 vs. 0.7+/-1.3 days), the time to achieve full enteral feeding was significantly shorter, and the weight gain at corrected age of 36 weeks was significantly higher in era 2. Also the incidence of early and total confirmed sepsis, total parenteral nutrition induced cholestasis, was lower and the duration of hospitalization was significantly shorter in era 2 compared to era 1, without differences in the incidence of NEC, moderate to severe BPD, and severe IVH (> or =Gr III) between two eras. CONCLUSION: Early enteral trophic feeding in ELBWI within 24 hours after birth was safe and beneficial.