Effect of Early Enteral Nutrition in Severe Thoracic Trauma Patients Requiring Mechanical Ventilation: A Randomized Controlled Trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANYu-bo , CAOShou-qiang , ZHAOGui-bin , LIUCheng , ZHANGKai , HANJing-qian , DONGQing ,  CUIJian

Department of Thoracic Surgery, The Fourth Hospital of Harbin Medical University, Harbin 150001, P. R. China;

Corresponding author：

CUIJian, Email: cuijian111@sohu.com

Keywords：

Early enteral nutrition; Mechanical ventilation; Severe thoracic trauma

DOI：

10.7507/1007-4848.20150160

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical effects of early enteral nutrition in severe thoracic trauma patients requiring mechanical ventilation. Methods We randomly allocated 60 patients with thoracic trauma requiring mechanical ventilation into two groups by drawing lots including an early enteral nutrition (EEN) group and a parenteral nutrition (PN) group in our hospital between January 2013 and September 2014 year. There were 30 patients in each group. We compared the recovery results of the patients between the two groups. Results After the treatment of 7 and 14 days, indicators in the EEN group were better than before significantly and better than those in the PN group; diarrhea rate average days of ICU and the average days of hospital decreased significantly with statistical differences (P<0.05). There was no statistical difference in ventilator-associated pneumonia or the incidence of stress ulcer between the two groups (P>0.05). Conclusion Early enteral nutrition in severe chest trauma patients requiring mechanical ventilation may promote protein synthesis, improve the nutritional status of patients, correct negative nitrogen balance, reduce inflammation response, reduce the complications.

Citation： YANYu-bo, CAOShou-qiang, ZHAOGui-bin, LIUCheng, ZHANGKai, HANJing-qian, DONGQing, CUIJian. Effect of Early Enteral Nutrition in Severe Thoracic Trauma Patients Requiring Mechanical Ventilation: A Randomized Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 629-633. doi: 10.7507/1007-4848.20150160 Copy

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5.	赵桂彬, 曹守强, 张凯, 等. 早期肠内营养对食管癌患者术后免疫功能和临床结局的影响. 中华胃肠外科杂志, 2014, 17(4):356-360.
6.	Sun JK, Mu XM, Li WQ, et al. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol, 2013, 19(6):917-922.
7.	McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr, 2009, 33(3):277-316.
8.	Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients:a systematic review. Crit Care Med, 2001, 29(12):2264-2270.
9.	Parker LA. Necrotizing enterocolitis:have we made any progress in reducing the risk? Adv Neonatal Care, 2013, 13(5):317-324.
10.	Davies AR, Morrison SS, Bailey MJ, et al. A multicenter, randomized controlled trial comparing early nasojejunal with nasogastricnutrition incritical illness. Crit Care Med, 2012, 40(8):2342-2348.
11.	Singh N, Sharma B, Sharma M, et al. Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis:a noninferiority randomized controlled trial. Pancreas, 2012, 41(1):153-159.
12.	Yost J, Ciliska D, Dobbins M. Evaluating the impact of an intensive education workshop on evidence-informed decision making knowledge, skills, and behaviours:a mixed methods study. BMC Med Educ. 2014, 1(17):14.
13.	Westergren A, Wann-Hansson C, Borgdal EB, et al. Malnutrition prevalence and precision in nutritional care differed in relation tohospital volume——a cross-sectional survey. Nutr J, 2009, 8(8):20.
14.	Gologanu D, Ionita D, Gartonea T, et al. Body composition in patients with chronic obstructive pulmonary disease. Maedica (Buchar), 2014, 9(1):25-32.
15.	Doig GS, Heighes PT, Simpson F, et al. Early enteral nutrition reduces mortality in trauma patients requiring intensive care:a meta-analysis of randomised controlled trials. Injury, 2011, 42(1):50-56.

1. Jivnani S, Iyer S, Umakumar K, et al. Impact of enteral nutrition on nitrogen balance in patients of trauma. J Emerg Trauma Shock, 2010, 3(2):109-114.
2. McKinzie BP. Evaluation of glucose variability when converting from insulin infusion to basal-bolus regimen in a surgical-trauma intensive care unit. J Crit Care, 2013, 28(5):804-809.
3. Heyland DK, Stephens KE, Day AG, et al. The success of enteral nutrition and ICU-acquired infections:a multicenter observational study. Clin Nutr, 2011, 30(2):148-155.
4. Kiss CM, Byham-Gray L, Denmark R, et al. The impact of implementation of a nutrition support algorithm on nutrition care outcomes in an intensive care unit. Nutr Clin Pract, 2012, 27(6):793-801.
5. 赵桂彬, 曹守强, 张凯, 等. 早期肠内营养对食管癌患者术后免疫功能和临床结局的影响. 中华胃肠外科杂志, 2014, 17(4):356-360.
6. Sun JK, Mu XM, Li WQ, et al. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol, 2013, 19(6):917-922.
7. McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr, 2009, 33(3):277-316.
8. Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients:a systematic review. Crit Care Med, 2001, 29(12):2264-2270.
9. Parker LA. Necrotizing enterocolitis:have we made any progress in reducing the risk? Adv Neonatal Care, 2013, 13(5):317-324.
10. Davies AR, Morrison SS, Bailey MJ, et al. A multicenter, randomized controlled trial comparing early nasojejunal with nasogastricnutrition incritical illness. Crit Care Med, 2012, 40(8):2342-2348.
11. Singh N, Sharma B, Sharma M, et al. Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis:a noninferiority randomized controlled trial. Pancreas, 2012, 41(1):153-159.
12. Yost J, Ciliska D, Dobbins M. Evaluating the impact of an intensive education workshop on evidence-informed decision making knowledge, skills, and behaviours:a mixed methods study. BMC Med Educ. 2014, 1(17):14.
13. Westergren A, Wann-Hansson C, Borgdal EB, et al. Malnutrition prevalence and precision in nutritional care differed in relation tohospital volume——a cross-sectional survey. Nutr J, 2009, 8(8):20.
14. Gologanu D, Ionita D, Gartonea T, et al. Body composition in patients with chronic obstructive pulmonary disease. Maedica (Buchar), 2014, 9(1):25-32.
15. Doig GS, Heighes PT, Simpson F, et al. Early enteral nutrition reduces mortality in trauma patients requiring intensive care:a meta-analysis of randomised controlled trials. Injury, 2011, 42(1):50-56.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of Early Enteral Nutrition in Severe Thoracic Trauma Patients Requiring Mechanical Ventilation: A Randomized Controlled Trial

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