Abstract
Aim. To determine the effectiveness and safety of early enteral protein nutrition (ЕEPN) using the clinical nutrition «FontActiv Forte Protein» to correct dysproteinemia and hypoalbuminemia in patients with esophageal variceal bleeding, gastric variceal bleeding in the context of liver cirrhosis during the post-hemorrhagic and postoperative periods. Materials and methods. The results of treatment of 71 patients who were treated in the Kyiv City Clinical Emergency Hospital were retrospectively analyzed. The first group of the study consisted of 34 patients who were treated between 2020-2024. The second control group of the study consisted of 37 patients treated between 2015 and 2019. All patients were admitted on an emergency basis for bleeding from esophageal varices in the setting of liver cirrhosis and were operated on after stabilization of hemodynamic parameters. Surgical treatment included porto-azigal disconnection: devascularization of the proximal stomach, distal esophagus, and hardware transection of the esophagus with or without splenectomy. Patients in the first study group received early enteral protein nutrition (EEРN) with protein mixtures (FontActive Forte Protein). Patients of the second control group received parenteral nutrition with Hepasol A, Hepasol Neo, enteral nutrition was started on day 6 of the postoperative period. Results. The intergroup comparison showed that all laboratory parameters, including the levels of total protein and albumin in the posthemorrhagic and early postoperative periods, decreased significantly in all patients of both groups and recovered slowly. Patients in the first group of the study who received REPX had a faster recovery of total protein and albumin, fewer complications, and shorter hospital stay after surgery (p<0.05). Conclusions. The administration of early enteral protein nutrition (FontActive Forte Protein) does not increase the risk of recurrent bleeding compared to delayed enteral nutrition. Nutritional support of protein homeostasis with liquid protein mixtures (FontActive Forte Protein) in patients with bleeding from esophageal/ gastric varices in the post-hemorrhagic/postoperative period is a safe method of correcting amino acid imbalance, reducing protein catabolism, maintaining protein synthesis function of the liver and serum albumin synthesis, which improves the results of surgical treatment, reduces the number of postoperative complications and the length of hospital stay.
Published Version
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