Newsletter

[ Vol. 11 No. 2 ] (May - August 2010 )
Comparative Analysis of various modalities of routes of administration of enteral feeding in surgical patients

Arshad Ahmad, Suresh Kumar, Vinod Jain, Sandeep Tewari
Department of Surgery, C S M Medical University, Lucknow, India

BACKGROUND
Malnutrition is well-recognized as potential cause of increased morbidity and mortality in surgical patients; however, enteral nutritional support given pre- and postoperatively have been shown to decrease these rates. General surgeons especially face nutritional challenges as many patients of wide variety of problems presenting at surgical emergency are malnourished. Pre existing diseases and emergency episode exaggerate malnutrition. Enteral feeding is the most ideal route of feeding. It preserves intestinal villi and maintains epithelial barrier function and normal absorptive processes and prevents intestinal bacterial translocation.

METHODS
We conducted a retrospective study to assess the short-term efficacy of enteral dietary supplementation in malnourished patients undergoing major abdominal surgery. We extended this observation on 140 patients undergoing surgery at Trauma Center. The age group varied 13 to 85 years with 98 males. Under this study, 70 patients had nasojejunal tubes, 32 had nasogastric tubes, 6 had gastrostomy and 32 had feeding jejunostomy tubes. Weight gain, intolerance to bolus and drip by drip feeds, infections, anastmotic dehiscence and length of hospital stay were compared in all the four groups.

RESULTS
Nasojejunal feeding was the most frequently preferred method as weight gain, tolerance, prevention of septic complications, technical ease and results were best. Although the number of patients required to achieve statistical significance was less, we look forward to continue the study and come out with a clear verdict. There is evidence that delivery of nutrients via the gastrointestinal tract reduces the septic morbidity and hospital stay in serious general surgical patients.

From  
PENSA 2009
“Energizing Nutrition Support Practice for Life”
June 5-7 2009, Shangri-La Hotel, Kuala Lumpur, Malaysia 
Page: 65