Abstract
Objective:To evaluate the effects of early enteral nutrition on the gastrointestinal motility and intestinal mucosal barrier of patients with burn-induced invasive fungal infection.Methods:A total of 120 patients with burn-induced invasive fungal infection were randomly divided into an early enteral nutrition (EN) group and a parenteral nutrition (PN) group (n=60). The patients were given nutritional support intervention for 14 days, and the expression levels of serum transferrin, albumin, total protein, endotoxin, D-lactic acid and inflammatory cytokines were detected on the 1st, 7th and 14th days respectively.Results:As the treatment progressed, the levels of serum transferrin, albumin and total protein of the EN group were significantly higher than those of the PN group (P<0.05), while the levels of serum endotoxin and D-lactic acid of the form group were significantly lower (P<0.05). After treatment, the expression levels of IL-6 and TNF-α were decreased in the EN group, which were significantly different from those of the PN group (P<0.05). During treatment, the incidence rates of complications such as abdominal distension, diarrhea, sepsis, nausea, vomiting and gastric retention were similar. The mean healing time of wound surface was 9.34±0.78 days in the EN group and 12.46±2.19 days in the PN group, i.e. such time of the former was significantly shorter than that of the latter (P<0.05).Conclusion:Treating patients having burn-induced invasive fungal infection by early enteral nutrition support with arginine can safely alleviate malnutrition and stress reaction, strengthen cellular immune function and promote wound healing, thereby facilitating the recovery of gastrointestinal motility and the function of intestinal mucosal barrier.
Highlights
IntroductionPatients with severe burn (a total burn area of over 30%) are in critical conditions
Patients with severe burn are in critical conditions
We evaluated the effects of early enteral nutrition on the gastrointestinal motility and intestinal mucosal barrier of patients with burn-induced invasive fungal infection
Summary
Patients with severe burn (a total burn area of over 30%) are in critical conditions. Enteral nutrition in combination with special nutrients can significantly reduce the duration of systemic inflammatory response syndrome and the incidence of multiple organ failure of burn patients.[7] Arginine can improve immune function, reduce catabolism, promote protein synthesis and protect gastrointestinal mucosa, with increasingly evident effects on clinical nutrition therapy.[8] In the meantime, arginine can relieve ischemia-reperfusion injury through gastrointestinal supplementation to help protect the function of intestinal mucosal barrier. Arginine metabolism is able to balance immune response, and polyamines are generated by the arginase pathway to enhance cell activity, to regulate immunity and macrophages, to inhibit platelet adhesion and to participate in sterilization.[9] Current studies have indicated that there are interactions between inflammatory response and burn coagulation, and severe burn patients are often accompanied by inflammation deficits.[10] To this end, we evaluated the effects of early enteral nutrition on the gastrointestinal motility and intestinal mucosal barrier of patients with burn-induced invasive fungal infection
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