Influence of enteral and parenteral nutrition support on gastric juice pH in patients with severe brain injury / 中华临床营养杂志

ABSTRACT

Objective To evaluate the influence of early entemal nutrition and parenteral nutrition support on gastric juice pH in patients with severe brain injury. Methods Totally 168 patients with severe brain injury ( Glasgow Coma Scale ≤ 8 ) admitted to our hospital from January 2007 to May 2009 were equally and randomly divided into early enternal nutrition (EEN) group and parenteral nutrition (PN) group. Gastric juice pH and upper gastrointestinal hemorrhage were monitored on admission and on the 3rd, 5th, and 7th day after admission. Results The gastric juice pH was significantly decreased in patients with severe brain injury. In addition, it was significantly higher in EEN group than in PN group on the 3rd, 5th, and 7th day after admission ( P ＜ 0. 001 ). The alimentary tract hemorrhage incidence showed no difference on admission between two groups but was significantly lower in the EEN group on the 3rd, 5th, and 7th day ( P ＜ 0. 05 ). Conclusions Hypersecretion of gastric acid may occur in patients with severe brain injury. EEN can neutralize gastric acid and increase gastric juice pH,which may lead to the decrease of upper gastriontestiual hemorrhage. Monitoring of the gastric juice pH also can provide a warning message of stress ulcer bleeding.