engleski

Early postoperative gastric enteral nutrition improve gastric emptying after cardiac surgery

Abstract Background: Postoperative intragastric enteral feeding in cardiac surgery patients is frequently complicated by delayed gastric emptying. Objective: To evaluate how early postoperative gastric enteral nutrition affects the gastric emptying in coronary artery by-pass graft (CABG) surgery patients. Methods: In the prospective, randomized study 40 patients treated at intensive care unit after CABG surgery were studied. Patients were divided in two groups: enteral feeding group E (20 patients: age 59&#177; ; 8 yr. ; male 70%) and control group C (20 patients: age 58&#177; ; 10 yr. ; male 80%), respectively. Paracetamol absorption test was used to evaluate gastric emptying. In the group E postoperative gastric supply of enteral formula begun 18 hours after surgery and after 6 hours the supply was stopped and paracetamol solution was administrated by nasogastric tube. The patients in group C for first 24 hours received only crystalloid solutions intravenously and paracetamol solution by nasogastric tube. Blood samples were obtained at 0 (t0), 15 (t+15), 30 (t+30), 60 (t+60) and 120 (t+120) min after administration of paracetamol. Results: The values of plasma paracetamol concentration (PPC) at 15 and 120 min were significantly higher in group E vs. group C: (t+15) 3.3&#177; ; 2.5 vs. 1.7&#177; ; 1.9 and (t+120) 5.2&#177; ; 2.8 vs. 3.3&#177; ; 1.6 (p <0.05). The PPC values at 30 and 60 min were higher, but not significantly, in group E vs. group C: (t+30) 3.7&#177; ; 2.0 vs. 2.9&#177; ; 2.7 and (t+60) 5.1&#177; ; 3.2 vs. 3.9&#177; ; 3.5 (p = NS). The area under the PPC curve was 429 &#177; ; 309 in the E group vs. 293 &#177; ; 204 in the group C (p < 0.05). Conclusion: An early postoperative gastric administration of nutritients after CABG surgery stimulates the gastric emptying.

early postoperative enteral nutrition; gastric emptying

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