Effect Of Early Enteral Nutrition Research Articles

Effects of early enteral nutrition on nutritional indicators and immune function in coma patients with brain injury

Effects of early enteral nutrition on nutritional indicators and immune function in coma patients with brain injury

Effect of early enteral nutrition with Bifico on levels of inflammatory mediators in plasma of patients with severe acute pancreatitis

Effect of early enteral nutrition with Bifico on levels of inflammatory mediators in plasma of patients with severe acute pancreatitis

Effect of early postoperative enteral nutrition on Chinese domestic gastric cancer patients:A Meta-analysis

Objective In order to evaluate the nutritional effect of early enteral nutrition in patients of Chinese domestic gastric cancer surgery,using evidence-based medicine methods,and supply evidence for clinical nutrition intervention.Methods CBM,Chinese academic Journals,Wanfang database and VIP Information Resource System were searched from January 2000 to March 2013 to collect the published clinical randomized controlled trials literatures of nutrition support in patients of Chinese domestic gastric cancer surgery according to inclusion and exclusion criteria of literature,using the Cochrane System Evaluation Handbook independent,double-blind principle of the literature methodology quality evaluation.Finally Meta analysis was conducted by using RevMan5.2 software.Results 14 articles were enrolled in the study,Meta analysis results showed that:early enteral nutrition comparing with parenteral nutrition in postoperative gastric cancer patients:the WMD of serum albumin was 1.55,95％ CI (0.81,2.29); the WMD of serum transferrin was 0.34,95％CI (0.30,0.38);the WMD of postoperative anal exhaust time was-20.66,95％CI (-23.91,-17.40).Conclusions Early enteral nutrition is better than the parenteral nutrition,which can restore adequate serum protein source for patients,and can recover the gastrointestinal digestion and absorption function of itself earlier,which is worthy of clinical promotion. Key words: Gastric cancer; Enteral nutrition; Early period; Meta-analysis

Effectiveness of parenteral nutrition and enteral nutrition support in the early stage after radical resection of gastric cancer

Objective To investigate the effectiveness and applied value of different nutritional support methods in the early stage after radical resection of gastric cancer.Methods 100 patients with gastric cancer subject to radical resection were randomly divided into two groups:total parenteral nutrition (TPN) group,and enteral nutrition (EN) combined with TPN (EN + TPN) group.Nutritional support was given 24 h after operation.The incidence of postoperative complications,gastrointestinal function recovery time,postoperative hospitalization days,and the indexes of immune function and nutrition assessment were analyzed.Results The incidence of postoperative complications in TPN group and EN + TPN group was 9％ and 3％,gastrointestinal function recovery time was (69.75 ± 9.49) h and (48.54 ±8.46) h,and the average hospital stay was (15.18 ± 2.21) days and (12.89 ± 2.23) days respectively (P ＜0.05 for all).In both two two groups after operation,the serum total protein (TP),plasma albumin (ALB),hemoglobin (HGB) and body weight (BW) were decreased after nutritional support to some extent (P ＜ 0.05).Lymphocyte count (LY) in TPN group was decreased (P ＜ 0.05),and no significant change was found in LY in EN + TPN group (P ＞ 0.05).There was no statistically significant difference in the indexes of immune function and nutrition assessment between two groups (P ＞ 0.05).Conclusion The effects of early EN combined with TPN improving the nutritional status of body after radical resection of gastric cancer were similar to those of PTN.Early EN combined with TPN could quickly improve the immune state and significant reduce the incidence of complications in comparison to TPN used alone. Key words: Gastric cancer; Nutritional support; Parenteral nutrition; Enteral nutrition

The effect of early enteral nutrition on severe acute pancreatitis

The effect of early enteral nutrition on severe acute pancreatitis

Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer.

To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme-linked immunosorbent assay (ELISA). After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (P<0.05), whereas the EN group had significantly higher albumin levels than the PN group (P<0.05). On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05). In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group (P<0.05) but significantly lower IL-2, IL-6, and TNF-α levels (P<0.05). In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune function.

Early enteral nutrition after pancreatoduodenectomy: a meta-analysis of randomized controlled trials

The aim of our study was to evaluate the safety and effectiveness of early enteral nutrition (EN) for patients after pancreatoduodenectomy (PD). We performed a comprehensive search of abstracts in the MEDLINE database, OVID database, Springer database, the Science Citation Index, and the Cochrane Library database. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of early EN and other nutritional routes for patients after PD were analyzed. The analyzed outcome variables included gastroparesis, intra-abdominal complications (gastroparesis excluded), mortality, infection, and postoperative hospital stay. The Cochrane Collaboration's RevMan 5.1 software was used for statistical analysis. Four RCTs published in 2000 or later were included in this meta-analysis, in which 246 patients underwent early EN and 238 patients underwent other nutritional routes following PD. In the combined results of early EN versus other nutritional routes, no significant difference could be found in gastroparesis (odds ratio (OR), 0.89; 95% CI, 0.36-2.18; P = 0.79), intra-abdominal complications (gastroparesis excluded) (OR, 0.82; 95% CI, 0.53-1.26; P = 0.37), mortality (OR, 0.43; 95% CI, 0.11-1.62; P = 0.21), infection (OR, 0.55; 95% CI, 0.29-1.07; P = 0.08), postoperative hospital stay (mean difference, -0.93; 95% CI, -6.51 to 4.65; P = 0.74). Current RCTs suggests that early EN appears safe and tolerated for patients after PD, but does not show advantages in infection and postoperative hospital stay.

Early Enteral Nutrition Prevents Intra‐abdominal Hypertension and Reduces the Severity of Severe Acute Pancreatitis Compared with Delayed Enteral Nutrition: A Prospective Pilot Study

To investigate the effects of early enteral nutrition (EEN) on intra-abdominal pressure (IAP) and disease severity in patients with severe acute pancreatitis (SAP). Enteral nutrition (EN) was started within 48 h after admission in the EEN group and from the 8th day in the delayed enteral nutrition (DEN) group. The IAP and intra-abdominal hypertension (IAH) incidence were recorded for 2 weeks. The caloric intake and feeding intolerance (FI) incidence were recorded daily after EN was started. The severity markers and clinical outcome variables were also recorded. Sixty patients were enrolled to this study. No difference about IAP was found. The IAH incidence of the EEN group was significantly lower than that of the DEN group from the 9th day (8/30 versus 18/30; P = 0.009) after admission. The FI incidence of the EEN group was higher than that of the DEN group during the initial 3 days of feeding (25/30 versus 12/30; P = 0.001; 22/30 versus 9/30; P = 0.001; 15/30 versus 4/30; P = 0.002). Patients with an IAP <15 mmHg had lower FI incidence than those with an IAP ≥15 mmHg on the 1st day (20/22 versus 17/38; P < 0.001), the 3rd day (11/13 versus 8/47; P < 0.001), and the 7th day (3/5 versus 3/55; P = 0.005) of feeding. The severity markers and clinical outcome variables of the EEN group were significantly improved. Early enteral nutrition did not increase IAP. In contrast, it might prevent the development of IAH. In addition, EEN might be not appropriate during the initial 3-4 days of SAP onset. Moreover, EN might be of benefit to patients with an IAP <15 mmHg. Early enteral nutrition could improve disease severity and clinical outcome, but did not decrease mortality of SAP.

Effect of early enteral nutrition with probiotics on gastrointestinal motility disturbance and nutritional status of patients with severe craniocerebral trauma

Objective To investigate effect of early enteral nutrition supplemented with probiotics on gastrointestinal motility disturbance and nutritional status in patients with severe craniocerebral trauma.Methods Forty patients with severe craniocerebral trauma were randomized into study group (18patients) and control group (22 patients).Patients of both groups received enteral nutrition via nasogastric tube at 24-72 hours after admission,but the patients of study group were also supplemented with probiotics simultaneously.Rate of abdominal distention,vomiting,gastro-oesophageal reflux,gastric retention,constipation and diarrhea were recorded during the whole study.Time to first defecation and time to targeted nutritional goals were also recorded.Prealbumin and transferrin in serum were detected at days 0,4,7,and 15 after the beginning of enteral nutrition.Length of ICU stay was compared between groups.Results There were no significant differences of the two groups in terms of rate of abdominal distention,vomiting,gastric retention and diarrhea.However,less gastro-oesophageal reflux or constipation patients were observed in study group,as compared with control group (P ＜ 0.05).Time to first defecation and time to targeted nutritional goals were shorter in study group,as compared with control group (P ＜ 0.05).Levels of prealbumin and transferrin had no significant differences between the two groups at days 0,4,and 7,but study group showed both were higher than control group at day 15 (P＜0.05).Moreover,length of ICU stay showed no significant difference between the two groups.Conclusions Compared with simple enteral nutrition,early enteral nutrition with probiotics improves gastrointestinal motility,facilitates the delivery of enteral nutrition,and further ameliorates nutritional status in patients with severe craniocerebral trauma. Key words: Craniocerebral trauma; Prebiotics; Enteral nutrition; Nutritional status ; Gastrointestinal motility

The effects of early enteral nutrition with addition of probiotics on the prognosis of patients suffering from severe acute pancreatitis

To investigate the curative effect of early enteral nutrition (EN) supplemented with probiotics (bifidobacterium) in patients with severe acute pancreatitis (ASP). Seventy SAP cases admitted from January 2005 to October 2012 were randomly assigned into parenteral nutrition (PN) group (n=22), EN group (n=25) and bifidobacterium added EN (P+EN) group (n=23). In P+EN group, patients were given their nutrition the same as that of EN, and also probiotics (bifidobacterium, 4 capsules every 12 hours, given through nasal gastric tube, each capsule weighing 210 mg). The routine treatment including anti-infection and anti-acid agents, and that of inhibition of pancreatic secretion were given, except for the different nutritional interventions in all groups. The blood samples were collected for e same measurements of interleukin-8 (IL-8) and tumor necrosis factor (TNF-α) by enzyme linked immunosorbent assay (ELISA), and for the C-reactive protein (CRP), lactic acid dehydrogenase (LDH), white blood cell (WBC) count, amylase and lipase by biochemistry assay 1 day before intervention of nutrition, and 7 days and 14 days after intervention. Changes in organ function and outcome were also recorded at the same time points. The plasma levels of IL-8, TNF-α, CRP, LDH, WBC count, amylase and lipase were significantly reduced after nutritional intervention compared with their levels on day 1 before intervention in all three groups. The plasma IL-8, TNF-α, CRP, lipase, LDH at 14 days after intervention of nutrition in P+EN group were significantly lower than those in PN group and EN group (IL-8: 21.00 ± 7.07 μg/L vs. 48.00 ± 10.32 μg/L, 32.00 ± 9.30 μg/L; TNF-α: 44.3 ± 10.9 ng/L vs. 132.1 ± 34.1 ng/L, 67.8 ± 22.3 ng/L; CRP: 35.0 ± 12.4 mg/L vs. 103.2 ± 49.2 mg/L, 63.0 ± 29.2 mg/L; lipase: 269 ± 79 U/L vs. 670 ± 145 U/L, 310 ± 78 U/L; LDH: 21.8 ± 10.3 U/L vs. 78.1 ± 37.4 U/L, 37.9 ± 25.1 U/L, P<0.05 or P<0.01). The WBC count in P+EN group was significantly lower than that in PN group (5.9 ± 3.0 × 10⁹/L, 6.3 ± 3.2 × 10⁹/L vs. 9.6 ± 3.0 ×10⁹/L, both P<0.05), but there was no significant difference in amylase between P+EN group and PN group (211 ± 49 U/L, 236 ± 52 U/L vs. 298 ± 71 U/L, P>0.05). The gastrointestinal dysfunction score in P+EN, EN, PN groups 14 days after nutritional intervention was 0.28 ± 0.05, 0.43 ± 0.09, 0.71 ± 0.11, respectively, with statistically significant differences (all P<0.01). Compared with PN and EN groups, the incidence of upper gastrointestinal bleeding (1 vs. 9, 2), infection and abscess (2 vs. 12, 5) was lower (all P<0.01), and hospital day was significantly shortened in P+EN group (10.4 ± 3.9 days vs. 25.8 ± 6.4 days, 13.4 ± 5.2 days, both P<0.01). There was no significant statistical difference in mortality rate among three groups. Our results indicated that early EN with addition of probiotics (bifidobacterium) resulted in significant lowering of the level of pro-inflammatory cytokines, earlier restoration of gastrointestinal function, decrease of complications such as infection, and shortening of hospital day in patients with SAP.

Effects of early enteral nutrition on immune function of severe acute pancreatitis patients

To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP). Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN). Enteral nutrition was started within 48 h after admission in EEN group, whereas from the 8(th) day in DEN group. All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1, 3, 7 and 14 after admission. The clinical outcome variables were also recorded. Sixty SAP patients were enrolled to this study. The CD4+ T-lymphocyte percentage, CD4+/CD8+ ratio, and the CRP levels in EEN group became significantly lower than in DEN group from the 7(th) day after admission. In contrast, the immunoglobulin G (IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7(th) day after admission. No difference of CD8+ T-lymphocyte percentage, IgM and IgA levels was found between the two groups. The incidences of multiple organ dysfunction syndrome, systemic inflammatory response syndrome, and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group. However, there was no difference of hospital mortality between the two groups. EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression. EEN can improve the clinical outcome, but not decrease the hospital mortality of SAP patients.

Effect of early enteral combined with parenteral nutrition in patients undergoing pancreaticoduodenectomy

To investigate the effect of early enteral nutrition (EEN) combined with parenteral nutritional support in patients undergoing pancreaticoduodenectomy (PD). From January 2006, all patients were given EEN combined with parenteral nutrition (PN) (EEN/PN group, n = 107), while patients prior to this date were given total parenteral nutrition (TPN) (TPN group, n = 67). Venous blood samples were obtained for a nutrition-associated assessment and liver function tests on the day before surgery and 6 d after surgery. The assessment of clinical outcome was based on postoperative complications. Follow-up for infectious and noninfectious complications was carried out for 30 d after hospital discharge. Readmission within 30 d after discharge was also recorded. Compared with the TPN group, a significant decrease in prealbumin (PAB) (P = 0.023) was seen in the EEN/PN group. Total bilirubin (TB), direct bilirubin (DB) and lactate dehydrogenase (LDH) were significantly decreased on day 6 in the EEN/PN group (P = 0.006, 0.004 and 0.032, respectively). The rate of grade I complications, grade II complications and the length of postoperative hospital stay in the EEN/PN group were significantly decreased (P = 0.036, 0.028 and 0.021, respectively), and no hospital mortality was observed in our study. Compared with the TPN group (58.2%), the rate of infectious complications in the EEN/PN group (39.3%) was significantly decreased (P = 0.042). Eleven cases of delayed gastric emptying were noted in the TPN group, and 6 cases in the EEN/PN group. The rate of delayed gastric emptying and hyperglycemia was significantly reduced in the EEN/PN group (P = 0.031 and P = 0.040, respectively). Early enteral combined with PN can greatly improve liver function, reduce infectious complications and delayed gastric emptying, and shorten postoperative hospital stay in patients undergoing PD.

Effects of Post‐transplant Enteral Nutrition with an Immunomodulating Diet Containing Hydrolyzed Whey Peptide after Liver Transplantation

Complications due to infections, including bacteremia, often arise after liver transplantation (LT) and are the most frequent causes of in-hospital death. Hydrolyzed whey peptide (HWP), a protein complex derived from milk, has anti-inflammatory effects. The present study retrospectively analyzes the effects of early enteral nutrition with a new immunomodulating diet (IMD) enriched with HWP in patients after living-donor LT (LDLT). Data from 76 consecutive adult patients who underwent LDLT at our institute between September 2009 and March 2011 were retrospectively analyzed. The new IMD enriched with HWP and a conventional elemental diet were administered enterally to 40 (HWP group) and 36 (control group) patients, respectively, within the first 24 h after surgery. The characteristics of patients and surgical parameters did not differ between the two groups. The incidence of bacteremia was significantly lower in the HWP (15%) than in the control group (47%) (p = 0.002). The in-hospital mortality due to infection was a little lower in the HWP group than in the control group, although there was no statistical difference (p = 0.145). The fasting blood glucose level at postoperative day 7 was significantly lower in the HWP group than in the control group (p = 0.005). The incidence of acute cellular rejection was similar between the two groups (p = 0.858). Early enteral nutrition with the new IMD enriched with HWP can prevent post-transplant bacteremia and post-transplant hyperglycemia without increasing the incidence of acute cellular rejection.

Effects of early enteral and parenteral nutrition after biliary enterostomy on the intestinal immune barrier and endotoxin of rats

Objective To compare the effects of early enteral nutrition(EN)and parenteral nutrition(PN)after biliary enterostomy on the intestinal immune barrier and endotoxin by establishing a simple animal model.Methods 30 male Wistar rats were randomly divided into 3 groups,the control,EN and PN groups,10 rats for each group,and different nutritional routes employed.7 days after animal model establishment,2 cm ileum in length 3 cm away from cecum were resected,CD4+,CD8+ T lymphocytes were detected by flow cytometry technique,portal vein blood was taken simultaneously to detect endotoxin.Resulst Comparing with control and PN groups,the percentage of CD4+T lymphocytes and CD4/CD8 of EN group were higher(P＜ 0.05); its portal vein endotoxin level significantly lower than that of the formers.Conclusion Early EN after biliary enterostomy for obstructive jaundice has protective effects on intestinal immune defense.It is helpful to decrease postoperative intestinal derived infection. Key words: Obstructive jaundice; Enteralnutrition; Intestinal mucosalimmune; Rats

Effect of early enteral nutrition after hepatectomy in hepatocellular carcinoma patients

Backgrounds/AimsTo evaluate the effect of early enteral nutrition after hepatectomy in hepatocellular carcinoma (HCC) patients on postoperative gastrointestinal motility recovery and admission days, liver function and nutrition recovery, and postoperative complication.MethodsFrom August 2010 to July 2011, 102 patients with primary HCC underwent hepatectomy. Forty two patients took a sip of water (SOW) at postoperative day (POD)#1, soft blended diet (SBD) at POD#2 (early diet group, ED group), otherwise 60 patients took a SOW at POD#3, SBD at POD#4 (conventional diet group, CD group). Postoperative flatus-pass day, stool-pass day, nausea, vomiting, admission days, immediate postoperative (POD#0) and POD#1, 3, 5, 7 profiles of albumin, prothrombin time (PT) INR, total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), white blood cell (WBC), and POD#1, 3, 5, 7 profiles of C-reactive protein (CRP), and postoperative complications cases were compared between ED group and CD group. All clinical data were compared retrospectively.ResultsFlatus-pass days (p<0.01), stool-pass days (p<0.01) and postoperative admission days (p=0.012) were shorter in ED group. Total bilirubin levels were higher at POD#0, 1, 3 but lower or similar at POD#5, 7 in ED group. AST, ALT levels were higher at POD#0 but lower at POD#1, 3, 5. There were no significant differences in albumin, PT INR, WBC, CRP and postoperative complication rates.ConclusionsED group had no difference in nutritional recovery and postoperative complication rates compared to CD group but it has better gastrointestinal motility recovery, liver function recovery, and shorter postoperative admission days.

The Effect of Early Enteral Nutrition on Hyperthermic Intraoperative Intraperitoneal Chemotherapy–Induced Mucosal Permeability Following Gastrectomy

To investigate (1) the effect of hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) on intestinal permeability of patients with advanced gastric cancer and (2) the protective effect of postoperative enteral nutrition (EN) on patients. All patients were divided randomly into 3 groups: the EN group, treated with EN during postoperative period; the EN+HIIC group, treated with HIIC and postoperative EN; and the PN+HIIC group, treated with HIIC and postoperative parenteral nutrition. The lactulose/mannitol (L/M) ratio was used to evaluate the permeability of intestinal mucous. Compared with the ratio of L/M on the day before operation (POD-1), the ratio of L/M on POD+3 increased significantly in all 3 groups (P < .0001) and then decreased gradually. The L/M ratio of the EN and EN+HIIC groups recovered to the baseline on POD+12. In contrast, the PN+HIIC group still had an elevated L/M ratio until POD+12. The ratios of L/M in the EN+HIIC group on POD+7 and POD+12 were significantly different from those of the PN+HIIC group (0.0855 ± 0.0462 vs 0.1298 ± 0.063, P = .007; 0.0336 ± 0.0235 vs 0.0616 ± 0.0430, P = .038, respectively). Gastric cancer radical resection resulted in a significant increase in intestinal permeability. HIIC aggravated the injury of intestinal mucous permeability, which could be reversed by EN.

Ernährung bei Intensivpatienten

The prognostic impact of inadequate energy and protein supply in malnourished intensive care patients has been recently reemphasized. Consent exists about the beneficial effects of early enteral nutrition in the critically ill. However, gastrointestinal intolerance of the critically ill may be a major problem for the feasibility of enteral nutrition bearing additional risks. In case adequate enteral nutrition cannot be realized, there is controversy about the appropriate time to start total parenteral or combined enteral / parenteral nutrition. Due to potential adverse effects immune-enhancing substrates have to be cautiously administered. For standardization implementation of a guideline based nutritional protocol is recommended. The review refers to the recent guidelines of the European Society for Clinical Nutrition and Metabolism (2009), the American Society for Parenteral and Enteral Nutrition (ASPEN) (2009) and the German Sepsis Society (DSG) (2010).

A survey of current practice patterns in prophylaxis against venous thromboembolism (VTE) and gastrointestinal (GI) ulceration among Canadian burn centers

Prospective data on efficacy of routine thromboprophylaxis in burn population remains limited. We believe that this uncertainty has lead to diverse management practices across Canada. Similarly, despite data supporting effectiveness of early enteral nutrition (EEN) for gastrointestinal (GI) ulcer prophylaxis, we hypothesize that many burn centers continue to use additional medical prophylaxis. A questionnaire was sent to 16 Canadian burn units regarding their practices of venous thromboembolism (VTE) and GI ulcer prophylaxis. We had 50% response rate. Fifty percent of respondents reported routine use of VTE prophylaxis in all their burn patients regardless of risk factors, 75% of these were among the largest burn centers in Canada. Only 1 center reported use of low molecular weight heparin, Enoxaparin, as their only mode of prophylaxis. With regards to GI ulcer prophylaxis, 62.5% of respondents indicated limiting use of ulcer prophylactic medications to ICU patients. Three (37.5%) centers reported practicing EEN for prophylaxis, 1 of which administered it as the sole modality. 7 of 8 centers used additional pharmacologic prophylaxis, most commonly an H2-blocker, ranitidine. There remains lack of consensus among Canadian burn centers in areas of VTE and GI ulcer prophylaxis, reflecting the limited prospective data in these fields.

Effect of early enteral nutrition supplemented with glutamine on postoperative intestinal mucosal barrier function in patients with gastric carcinoma

To investigate the effect of early enteral nutrition (EEN) supplemented with glutamine on postoperative intestinal mucosal barrier function of patients with gastric carcinoma. Eighty patients with gastric carcinoma who underwent intraoperative peritoneal hyperthermic chemotherapy(IPHC) were randomized into two groups: EEN+glutamine (EEN+Gln) group(n=40) and EEN group(n=40). Intestinal mucosal barrier function was evaluated by serum diamine oxidase (DAO), ratio of lactulose to mannitol(L/M), endotoxin lipopolysaccharides(LPS), and tumor necrosis factor-α(TNF-α) at 1 day before operation, 1 day, 7 days, 12 days after operation. Time to first flatus and tolerance to EEN were recorded as well. There were no significant differences in the two groups in demographics(all P>0.05). Two cases(5%) in the EEN+Gln group and 1 case (2.5%) in the EEN group could not tolerate well(P>0.05). On postoperative day 1, there were no differences in serum DAO, L/M ratio, LPS, TNF-α between the two groups (P>0.05). On postoperative day 7, all the parameters for mucosal barrier function were significantly lower in the EEN+Gln group. On postoperative day 12, the urinary L/M and DAO, LPS, and TNF-α were still significantly lower in the EEN+Gln group, however, urinary L/M was comparable between the two groups. There were no differences between the two groups in the time to first flatus (P>0.05). The immunologic tolerance of enteral nutrition supplemented with glutamine is favorable, which provides protective effect on intestinal mucosal barrier in patients with gastric carcinoma undergoing IPHC.

Effect of early enteral nutrition on morbidity and mortality in children with burns

Effect of early enteral nutrition on morbidity and mortality in children with burns