Effects of enteral nutrition solution with different temperatures on gastrointestinal dysfunction after severe head injury surgery

Abstract

Objective To explore the effects of enteral nutrition (EN) solution with different temperatures on gastrointestinal dysfunction after severe head injury surgery. Methods From January 2016 to December 2016, we selected 220 patients with severe head injury surgery in intensive care unit (ICU) at Tianjin Medical University General Hospital. All of the patients were randomly divided into observation group A (n=74) , observation group B (n=73) and observation group C (n=73) according to the sequence of being admitted to hospital. Setting range of temperature of EN was from 35.0 to 36.8℃ in observation group A, from 36.9 to 37.9℃ in observation group B and from 38.0 to 42.0℃ in observation group C. We compared gastric motility, intestinal barrier function, time of EN and of reaching target of EN. Results There were statistical differences in intra-abdominal pressure (IAP) , gastric residual volume (GRV) , serum diamine oxidase activity and D-lactate concentration in three groups (F=63.458, 11.002, 26.972, 18.827; P<0.001) . The IAP and GRV of observation group C were significantly lower than those of observation group A (t=-11.215, -4.694; P<0.001) and observation group B (t=-6.462, -2.452; P<0.05) ; those of observation group B were significantly lower than those of observation group A (t=-4.731, -2.234; P<0.05) . The serum diamine oxidase activity and D-lactate concentration of observation group C were lower than those of observation group A (t=-7.263, -6.115; P<0.001) and observation group B (t=-2.712, -3.471; P<0.05) ; those of observation group B were significantly lower than those of observation group A (t=-4.542, -2.631; P<0.05) . Patients' time of EN and of reaching target of EN were significant differences in three groups (F=41.537, 10.892; P<0.001) . The time of EN of observation group C was significantly lower than that of observation group A and observation group B (t=-8.522, -7.065; P<0.001) ; there was no statistical difference in that of observation group A and observation group B (t=-1.433, P=0.153) . The time of reaching target of EN in observation group C and observation group B was lower than that of observation group A (t=-4.587, -3.108; P<0.05) ; there was no significant difference in that between observation group B and observation group C (t=1.474, P=0.142) . Conclusions EN solution with different temperatures have effects on gastrointestinal function among patients after severe head injury surgery. The nutrient solution with temperature from 38.0 to 42.0 ℃ can effectively improve gastric motility and intestinal barrier function, and is conducive to reducing the time of EN and of reaching target of EN. Key words: Temperature; Enteral nutrition; Severe craniocerebral trauma; Gastrointestinal dysfunction