Early enteral trophic feeding for improvement of intestinal mucosa barrier in seriously traumatic patients
10.3760/cma.j.issn.1671-0282.2017.09.014
- VernacularTitle:早期肠内滋养对重症创伤患者肠黏膜屏障的改善作用研究
- Author:
Shigang QIAO
1
,
2
;
215153江苏省苏州,南京医科大学附属苏州医院临床医学研究所
;
Lichao FANG
;
Kun AN
;
Chengdong SUN
;
Nan YUAN
;
Cheng FAN
;
Zhiheng MA
;
Yachun ZHU
;
Xiaomin WANG
Author Information
1. 215153江苏省苏州,苏州科技城医院麻醉及围术期医学科
2. 215153江苏省苏州,南京医科大学附属苏州医院临床医学研究所
- Keywords:
Early enteral trophic feeding;
Trauma;
Intestinal mucosa barrier;
Permeability;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2017;26(9):1050-1053
- CountryChina
- Language:Chinese
-
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.
