To compare the method of early enteral nutrition to parenteral nutrition about the immunology, nutriments and side effects on severe traumatic patients, the study was carried on traumatic patients who were treated in surgical ICU of Vietduc hospital from April to October 2003. There are 36 patients in group of early enteral nutrition and 23 patients in group of parenteral nutrition. We found no difference about age, severity of trauma, time of artificial ventilation and hospitalization between two groups of patient. IgA results of parenteral nutrition group decreased more significantly than IgA of enteral nutrition group after 8 days of nutrition, but lymphocyte count increased (p<0.05) in this groups. After nutrition, albuminemia had no change, but total proteinemia increased in two groups. Transferrin and hematocrit were not different between two groups. We also found that diarrhea is a side effect of enteral nutrition method (22%).The price of enteral nutrition was 3.7 times cheaper than parenteral nutrition.
Nutritional Status ; Parenteral Nutrition ; Wounds and Injuries

Study 460 patients with cranial trauma who were treated ventilation at Viet Duc Hospital from 1999 October to 2003 March. Results: the rates of respiratory infection in 2 groups using different primary treatments were similar. Most causes of respiratory infection were Pseudomonas aeruginosa and Acinetobacter, but infection of Acinetobacter in group received cefotamixin was more common than cefradin group. E. coli infection in cefradin group was significantly higher than cefotaxim group. Bacteria caused respiratory infection in patients who used more broad-spectrum antibiotics are more resistant to antibiotics
Respiratory Tract Infections ; Bacteria ; Ventilation

Background: Although there are many advances in the treatment of Acute Respiratory Distress Syndrome (ARDS), the mortality rate is still high (40%-60%). The new strategy \u2018protective ventilation\u2019 helped to lower the fatality rate and shortening the duration of mechanical ventilation in comparison with traditional modes. However, there is controversy about the effects of protective ventilation. Objectives: (1) To estimate the change of arterial blood gas and hemodynamic in the first 48hrs in the patients suffering from ALI or ARDS under protective ventilation. (2) To discover the disadvantages of this ventilation mode. Subjects: 30 ALI and ARDS patients (22 males and 8 females) treated at ICU, Viet Duc Hospital between April 2005 and October 2005. Method: Prospective and self-control study. Protective ventilation was applied for these patients. Artery blood gas, hemodynamic and disadvantages of protective ventilation were monitored during first 48hrs. Results: Protective ventilation significantly lowers airway pressure (p < 0.001). There was no change of PaCO2 (p > 0.05), and PaO2 was improved clearly after 12hrs of ventilation (p < 0.05). There were no significant changes of mean arterial pressure, heart rate and central venous pressure. 83.3% patients needed a high dose of sedation during protective ventilation. Conclusion: Protective ventilation lowered airway pressure, improved PaO2 and had no hemodynamic effect. However, patients required a high dose of sedation during this mode of ventilation.
Protective ventilation ; acute lung injury ; acute respiratory distress syndrome