Early postoperative gastric enteral nutrition improve gastric emptying after cardiac surgery

Abstract

<jats:title>Abstract</jats:title><jats:p>Postoperative intragastric enteral feeding in cardiac surgery patients is frequently complicated by delayed gastric emptying. The aim of the study was to evaluate how early postoperative gastric enteral nutrition affects the gastric emptying in coronary artery by-pass graft (CABG) surgery patients.</jats:p><jats:p>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±8 yr.; male 70%) and control group C (20 patients: age 58±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.rst 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.</jats:p><jats:p>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±2.5 vs. 1.7±1.9 and (t+120) 5.2−2.8 vs. 3.3±1.6 (p &lt;0.05). The PPC values at 30 and 60 min were higher, but not signi.cantly, in group E vs. group C: (t+30) 3.7±2.0 vs. 2.9±2.7 and (t+60) 5.1±3.2 vs. 3.9±3.5 (p = NS). The area under the PPC curve was 429 ± 309 in the E group vs. 293 ± 204 in the group C (p &lt; 0.05).</jats:p><jats:p>In conclusion an early postoperative gastric administration of nutritients after CABG surgery stimulates the gastric emptying.</jats:p>

Association between illness severity and timing of initial enteral feeding in critically ill patients: a retrospective observational study

“…Consequently, as we were able to control diarrhea and GI bleeding, neither significantly affected nutritional intake. These results, however, are inconsistent with previous reports of early feeding improving GI function [ 4 , 6 ]. Critically ill patients suffer from a combination of physiological disturbances likely to influence GI function [ 22 , 24 ].…”

“…Early enteral feeding improves clinical outcomes, reduces gastric intolerance, and promotes early reestablishment of gastroduodenal motility [ 4 , 5 ]. Patients experiencing early enteral feeding (within 24 to 48 h following ICU admission) demonstrate reduced gut permeability and cytokine release, compared to late enteral feeding patients (after 72 h) [ 6 ].…”

Immediate preoperative enteral nutrition (preoperative enteral nutrition)

“…Enteralna ishrana, kao način nutritivne potpore, održava integritet crevne barijere, aktivnost imunog sistema digestivnog trakta i njegovu perfuziju. Korišćenjem rane enteralne ishrane, smanjuje se broj postoperativnih komplikacija i ubrzava se oporavak bolesnika 5 . Možemo reći da: Svi bolesnici koji su pothranjeni ili imaju rizik od nastanka pothranjenosti imaju korist od preoperativne enteralne nutritivne potpore.…”