Avtor/Urednik		Kompan, L; Kremžar, B; Gadžijev, E; Prošek, M
Naslov		Effects of early enteral nutrition on intestinal permeability and the development of multiple organ failure after multiple injury
Tip		članek
Vir		Intensive Care Med
Vol. in št.		Letnik 25, št. 2
Leto izdaje		1999
Obseg		str. 157-61
Jezik		eng
Abstrakt		Objective: To determine how immediate enteral nutrition (EN) affects gut permeability and the development of multiple organ failure (MOF) in multiply injured patients. Design: Prospective, randomised clinical trial. Setting: 20-bed surgical intesive care unit (ICU), university hospital. Patients: 28 consecutive multiply injured patients, admitted in shock and stabilised in 6h. Interventions: Patients were randomly assigned to EN started not later than 6h after admission to the ICU (group A), and to EN started later than 24h after admission (group B). Measurements and main results: The lactulose/mannitol (L/M) test was performed in patients on days 2 and 4 after trauma, and in 5 healthy volunters. MOF scores were calculated daily. The mean MOF score from day 4 onwards was 1.84 in group A versus 2.81 in group B (p < 0.002), and was correlated with the time of initiation of EN after injury and the L/M ratio on day 2. The mediam L/M ratio on day 2 was 0.029 for group A and 0.045 for group B, while on day 4 it was 0.020 and 0.060, respectively. On day 2 after trauma, the L/M ratio was significantly higher in group B (p<0.05) than in normal volunteers (median 0.014) and was positively correlated with the time of starting EN. Conclusions: In contrast with normal volunteers, the patients started on EN later than 24h after admision to the ICU demonstrated increased intestinal permeability on the second day after sustaining multiple injury. Also, they had a more severe form of MOF than the group placed on EN immediately upon admission. However, early EN had no influence on the lenght of ICU stay or the time of mechanical ventilation.
Deskriptorji		MULTIPLE ORGAN FAILURE ENTERAL NUTRITION MULTIPLE TRAUMA INTESTINAL ABSORPTION LACTULOSE MANNITOL