Sequential changes of body composition in patients with enterocutaneous fistula during the 10 days after admission.

Abstract

To investigate the sequential changes of body composition in the metabolic response that occurred in a group of patients with enterocutaneous fistula after admission to the hospital. Sixty-one patients with enterocutaneous fistula admitted to our hospital had measurements of body composition by multiple-frequency bioelectrical impedance analysis after admission and 5, 10 days later. Sequential measurements of plasma constitutive proteins were also made. The body weight, fat-free mass, body mass index, and body cell mass were initially well below the normal range, especially the body mass index and body cell mass. And all the data gradually moved up over the 10-day study period, only a highly significant difference was found in body cell mass. Once the patients received nutrition supplement, ECW began to return to normal range slowly as well as ICW and TBW began to rise up, and ECW/TBW significantly declined to near normal level by day 10 in either male or female patients. There was a reprioritization of plasma constitutive protein synthesis that was obligatory and independent of changes in FFM. Serial measurements can quantify the disturbance of body composition in enterocutaneous fistula patients. The early nutritional intervention rapidly ameliorates the abnormal distribution of body water while the state-of-the-art surgical management prevents the further deterioration in cellular composition.