Naslov
Early postoperative gastric supply of nutrients improve gastric emptying after cardiac surgery

Autori
Šustić, Alan ; Zelić, Marko ; Reljić, Marijana ; Župan, Željko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Mjesto i datum
,

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
Enteral feeding; gastric emptying

Sažetak
INTRODUCTION: Recently, it has been demonstrated that early enteral feeding after multiple injury diminishes gastric intolerance towards food and promotes speedier establishment of motility in gastro-duodenal segment of digestive tract 1. The aim of the study was to establish how early postoperative gastric supply of nutrients affects the gastric emptying in coronary artery by-pass graft (CABG) surgery patients. METHODS: In the prospective, randomized study 40 patients treated at cardiosurgical ICU after CABG surgery were studied. The patients were divided in two groups: protocol group E (group of early postoperative gastric supply of nutrients) (20 patients: age 59&#61617; 8 yr. ; male 70%) and control group C (20 patients: age 58&#61617; 10 yr. ; male 90%), respectively. The duration of surgery, anesthesia and cardiopulmonary by-pass, the NYHA score, age and sex were not statistically different between groups. In the patients from the both groups paracetamol absorption test was used to evaluate gastric emptying. In the group E postoperative gastric supply of standard isoosmotic enteral formula begun 18 hours after surgery (Fresubine, Frasenius Kabi ; 30/50 ml/h ; total 240 ml) by two-lumen nasogastric tube. After 6 hours of feeding the gastric supply was stopped and paracetamol solution (1000 mg) was administrated by nasogastric tube. The patients in group C for first 24 hours received only crystalloid solutions and after 24 hours paracetamol solution (1000 mg) was administrated, also by nasogastric tube. Venous blood samples were obtained from an indwelling peripheral cannula immediately before (t0) and at 15 (t+15), 30 (t+30), 60 (t+60) and 120 (t+120) min after administration of paracetamol. Paracetamol absorption was assessed from the plasma paracetamol concentration (PPC) and the area under the paracetamol concentration curve from 0 to 120 min (AUC). RESULTS: The values of PPC immediately before the administration of paracetamol (t0) was not significantly different between the groups: group E 2.4&#61617; 1.8 vs. group C 1.8&#61617; 1.8 (p = NS). The PPC values at 15 and 120 min were significantly higher in protocol group E vs. control group C: (t+15) 3.3&#61617; 2.5 vs. 1.7&#61617; 1.9 (p <0.05) and (t+120) 5.2&#61617; 2.8 vs. 3.3&#61617; 1.6 (p <0.05). The PPC values at 30 and 60 min were higher, but not significantly, in protocol group E vs. control group C: (t+30) 3.7&#61617; 2.0 vs. 2.9&#61617; 2.7 (p = NS) and (t+60) 5.1&#61617; 3.2 vs. 3.9&#61617; 3.5 (p = NS). The AUC value was 32% larger in the E group than in patients from C group. CONCLUSION: An early postoperative gastric supply of nutrients after CABG surgery probably stimulates the gastric emptying, preventing thus the gastric intolerance towards enteral formula.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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