Effect of early enteral nutrition on prognosis of patients with multiple rib fractures combined with acute respiratory distress syndrome

doi:10.3877/cma.j.issn.2095-9133.2015.03.009

Abstract

Abstract:

Objective

To explore the effect of early enteral nutrition on the prognosis of patients with multiple rib fractures combined with acute respiratory distress syndrome（ARDS）.

Methods

A retrospective analysis was conducted on 126 patients with severe chest trauma caused by multiple rib fractures and acute respiratory distress syndrome treated from June 2010 to July 2014.The patients were randomly divided into Group A（n=63，treated with enteral nutrition within 24-48 h after ICU stay） and Group B（n=63，treated with enteral nutrition 48 h after ICU stay）.The rest of the treatment was the same in both groups.The incidence of high blood sugar，stress ulcer and pulmonary infection was compared between two groups.

Results

The incidences of high blood sugar，stress ulcer and pulmonary infection were 11% （7/63），13% （8/63）and 83% （52/63） respectively in Group A but were 29% （18/63），32% （20/63） and 95% （60/63）respectively in Group B.

Conclusion

For patients with severe chest trauma induced multiple rib fractures combined with acute respiratory distress syndrome，early enteral nutrition can decrease the incidence of high blood sugar，stress ulcer and pulmonary infection and hence improve the prognosis of patients.

Key words: Enteral nutrition, Multiple rib fractures, Acute respiratory distress syndrome, Prognosis

Yan Xin, Zhizhong Chang, Guoxin Li, Qilin Li. Effect of early enteral nutrition on prognosis of patients with multiple rib fractures combined with acute respiratory distress syndrome[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2015, 01(03): 29-32.

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References 23

1	Simpson F，Doig GS.Parenteral vs.enteral nutrition in the critically ill patient： a meta-analysis of trials using the intention to treat principle［J］.Intensive Care Med，2005，31（1）：12-23.
2	The ARDS Definition Task Force. Acute respiratory distress syndrome：the Berlin definition［J］.JAMA，2012，307：2526-2533.
3	Ferguson ND，Fan E，Camporota L，et al.The Berlin definition of ARDS： an expanded rationale，justification，and supplementary material［J］.Intensive Care Med，2012，38（10）：1573-1582.
4	Ibrahim EH，Mehringer L，Prentice D，et al.Early versus late enteral feeding of mechanically ventilated patients： results of a clinical trial［J］.JPEN，2002，26（3）：174-181.
5	Kompan L，Kremzar B，Gadzijev E，et al.Effects of early enteral nutrition on intestinal permeability and the development of multiple organ failure after multiple injury［J］.Intensive Care Med，1999，25（2）：157-61.
6	陆在英，钟南山.内科学［M］.7 版.北京：人民卫生出版社，2008：150-155.
7	Levitt JE，Matthay MA.Treatment of acute lung injury：historical perspective and potential future therapies［J］.Semin Respir Crit Care Med，2006，27（4）：426-437.
8	孙甲君，杨茂捂，王长辉，等.低牵张通气策略救治急性呼吸窘迫综合征的临床研究［J］.中国危重病急救医学，2009，21（10）：609-612.
9	Ryter SW，Choi AM.Heme oxygenase-1/carbon monoxide：novel therapeutic strategies in critical care medicine［J］.Curr Drug Targets，2010，11（12）：1485-1494.
10	Mentec H，Dupont H，Bocchetti M，et al.Upper digestive intolerance during enteral nutrition in critically ill patients： Freqency，risk factors，and complications［J］.Crit Care Med，2001，29（10）：1955-1961.
11	Rost P，Bihari D.The route of nutritional support in the critically ill：physiological and economical considerations［J］.Nutrition，1997，13（9 Suppl）：58S-63S.
12	Hoover HC Jr，Ryan JA，Anderson EJ，et al.Nutritional benefits of immediate postoperative jejunal feeding of an elemental diet［J］.Am Surg，1980，139（1）：153-159.
13	Umpierrez GE，Isaacs SD，Bazargan N，et al.Hyperglycemia： an independent marker of in-hospital mortality in patients with undiagnosed diabetes［J］.J Clin Endocrinol Metab，2002，87（3）：978-982.
14	吴国豪.应激性高血糖及防治对策［J］.中国实用外科杂志，2005，25（1）：57-59.
15	Van den Berghe G，Wouters P，Weekers F，et al.Intensive insulin therapy in the critically ill patients［J］.N Engl J Med，2001，345（19）：1359-1367.
16	Krinsley JS.Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients［J］.Mayo Clin Proc，2003，78（12）：1471-1478.
17	Maton PN.Prevention of stress-related mucosal bleeding with protonpump inhibitors［J］.Aliment Pharmacol Ther，2005，22 （Suppl 3）：45-52.
18	金惠铭，王建枝.病理生理学［M］.北京：人民卫生出版社，2006.154-155.
19	American Thoracic Society，Infectious Diseases Society of America.Guidelines for the management of adults with hospitalacquired，ventilator-associated，and healthcare-associated pneumonia［J］.Am JRespir Crit Care Med，2005，171（4）：388-416.
20	Torres A，Ewig S，Lode H，et al.Defining，treating and preventing hospital acquired pneumonia： European perspective［J］.Intensive Care Med，2009，35（1）：9-29.
21	孙锦梅.肠内营养及其护理进展［J］.肠外与肠内营养，1998，5（2）：114-116.
22	Braunschweig CL，Levy P，Sheean PM，et al.Enteral compared with parenteral nutrition： a meta-analysis［J］.Am J Clin Nutr，2001，74（4）：534-542.
23	Gramlich L，Kichian K，Pinilla J，et al.Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients？ A systematic review of the literature［ J］.Nutrition，2004，20（10）：843-848.

组别	高血糖	应激性溃疡	肺部感染
A组	11（7/63）	13（8/63）	83（52/63）
B组	29（18/63）	32（20/63）	95（60/63）
χ ²	6.04	6.60	4.86
P值	＜0.05	＜0.05	＜0.05

组别	高血糖	应激性溃疡	肺部感染
A组	11（7/63）	13（8/63）	83（52/63）
B组	29（18/63）	32（20/63）	95（60/63）
χ ²	6.04	6.60	4.86
P值	＜0.05	＜0.05	＜0.05

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