Skip to main content
Gut logoLink to Gut
. 1994 Jan;35(1 Suppl):S52–S54. doi: 10.1136/gut.35.1_suppl.s52

Gut mucosal nutritional support--enteral nutrition as primary therapy after multiple system trauma.

K A Kudsk 1
PMCID: PMC1378148  PMID: 8125392

Abstract

Over the past 10 years, several clinical and experimental studies report the potential benefit of enteral nutrition as primary therapy after multiple system trauma. In this study, 98 patients sustaining blunt and penetrating trauma were randomised to receive either enteral or parenteral feeding for 15 days. There were significantly fewer infectious complications in patients randomised to receive enteral feeding with particular benefit shown in the most severely injured patients. Serum protein concentrations correlated with the clinical outcome with an increase in constitutive protein and decrease in acute phase protein concentrations occurring in the enteral group through a decrease in septic complications and possible direct hepatic 'reprioritisation'. Enteral feeding serves as a primary therapy affecting the outcome of critically ill patients.

Full text

PDF
S54

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alexander J. W., MacMillan B. G., Stinnett J. D., Ogle C. K., Bozian R. C., Fischer J. E., Oakes J. B., Morris M. J., Krummel R. Beneficial effects of aggressive protein feeding in severely burned children. Ann Surg. 1980;192(4):505–517. doi: 10.1097/00000658-198010000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Border J. R., Hassett J., LaDuca J., Seibel R., Steinberg S., Mills B., Losi P., Border D. The gut origin septic states in blunt multiple trauma (ISS = 40) in the ICU. Ann Surg. 1987 Oct;206(4):427–448. doi: 10.1097/00000658-198710000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Grahm T. W., Zadrozny D. B., Harrington T. The benefits of early jejunal hyperalimentation in the head-injured patient. Neurosurgery. 1989 Nov;25(5):729–735. doi: 10.1097/00006123-198911000-00007. [DOI] [PubMed] [Google Scholar]
  4. Herndon D. N., Barrow R. E., Stein M., Linares H., Rutan T. C., Rutan R., Abston S. Increased mortality with intravenous supplemental feeding in severely burned patients. J Burn Care Rehabil. 1989 Jul-Aug;10(4):309–313. doi: 10.1097/00004630-198907000-00004. [DOI] [PubMed] [Google Scholar]
  5. Kudsk K. A., Carpenter G., Petersen S., Sheldon G. F. Effect of enteral and parenteral feeding in malnourished rats with E. coli-hemoglobin adjuvant peritonitis. J Surg Res. 1981 Aug;31(2):105–110. doi: 10.1016/0022-4804(81)90037-8. [DOI] [PubMed] [Google Scholar]
  6. Kudsk K. A., Croce M. A., Fabian T. C., Minard G., Tolley E. A., Poret H. A., Kuhl M. R., Brown R. O. Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating abdominal trauma. Ann Surg. 1992 May;215(5):503–513. doi: 10.1097/00000658-199205000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kudsk K. A., Stone J. M., Carpenter G., Sheldon G. F. Enteral and parenteral feeding influences mortality after hemoglobin-E. coli peritonitis in normal rats. J Trauma. 1983 Jul;23(7):605–609. doi: 10.1097/00005373-198307000-00010. [DOI] [PubMed] [Google Scholar]
  8. Moore E. E., Jones T. N. Benefits of immediate jejunostomy feeding after major abdominal trauma--a prospective, randomized study. J Trauma. 1986 Oct;26(10):874–881. doi: 10.1097/00005373-198610000-00003. [DOI] [PubMed] [Google Scholar]
  9. Moore F. A., Moore E. E., Jones T. N., McCroskey B. L., Peterson V. M. TEN versus TPN following major abdominal trauma--reduced septic morbidity. J Trauma. 1989 Jul;29(7):916–923. doi: 10.1097/00005373-198907000-00003. [DOI] [PubMed] [Google Scholar]
  10. Peterson V. M., Moore E. E., Jones T. N., Rundus C., Emmett M., Moore F. A., McCroskey B. L., Haddix T., Parsons P. E. Total enteral nutrition versus total parenteral nutrition after major torso injury: attenuation of hepatic protein reprioritization. Surgery. 1988 Aug;104(2):199–207. [PubMed] [Google Scholar]
  11. Sganga G., Siegel J. H., Brown G., Coleman B., Wiles C. E., 3rd, Belzberg H., Wedel S., Placko R. Reprioritization of hepatic plasma protein release in trauma and sepsis. Arch Surg. 1985 Feb;120(2):187–199. doi: 10.1001/archsurg.1985.01390260051008. [DOI] [PubMed] [Google Scholar]
  12. Young B., Ott L., Twyman D., Norton J., Rapp R., Tibbs P., Haack D., Brivins B., Dempsey R. The effect of nutritional support on outcome from severe head injury. J Neurosurg. 1987 Nov;67(5):668–676. doi: 10.3171/jns.1987.67.5.0668. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES