Role of intestinal lavage in the normalization of the functions of the gastrointestinal tract in patients with chronic critical illness

Abstract

BACKGROUND: The resolution of intestinal insufficiency syndrome remains one of the urgent problems of nutritional support for patients with traumatic brain injury (TBI) and chronic critical illness.
 AIM: To determine the effectiveness of intestinal lavage in restoring the basic functions of the gastrointestinal tract and microbiocenosis in patients with chronic critical illness.
 MATERIALS AND METHODS: This prospective, randomized, single-center study analyzed 56 men with TBI of various etiologies and chronic critical illness. At the beginning of treatment and on day 10, the effectiveness of gastrointestinal lavage was evaluated as a complex intensive treatment of intestinal insufficiency syndrome.
 RESULTS: Patients were randomized into two groups depending on the conduct of intestinal lavage. In group 1 (n=27), enteral tube feeding was performed according to the standard method. In group 2 (n=29), intestinal lavage was also performed and an enterosorbent was added to the saline enterosorbent solution, three procedures with an interval of 3 days. A significant positive dynamics of carbohydrate and protein metabolism, restoration by day 10 of the barrier function of the intestine, motility of the gastrointestinal tract, and microbiocenosis were observed in group 2 (main group) compared with those in group 1 (control).
 CONCLUSION: The inclusion of gastrointestinal lavage in the complex intensive therapy for SCI in patients with a chronic critical illness for a short period helps resolve the main pathogenetic links of SCI restoration of the barrier function of the intestine, digestive transport, motor evacuation processes in the gastrointestinal tract, normalization of microbiocenosis, and metabolic parameters and nutritional status.