engleski

Early postoperative gastric enteral nutrition improves gastric emptying after non-complicated cardiac surgery

Background: Postoperative intragastric enteral feeding in cardiac surgery patients is frequently complicated by delayed gastric emptying. Objective: To evaluate how early postoperative gastric enteral nutrition affects gastric emptying in coronary artery by-pass graft (CABG) surgery patients. Methods: In this prospective, randomized study a group of 40 patients treated in the intensive care unit after CABG surgery were studied. Patients were divided in two groups: group E (20 patients: age 59± ; 8 yr. ; male 70%) and control group C (20 patients: age 58± ; 10 yr. ; male 80%), respectively. The paracetamol absorption test was used to evaluate gastric emptying. In group E gastric enteral nutrition begun 18 hours after surgery and 6 hours later this was stopped and paracetamol solution was administered. The patients in group C received only crystalloid solutions for first 24 hours. 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. Results: The values of plasma paracetamol concentration (PPC) at 15 and 120 min were significantly higher in group E when compared with .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 <0.05). The PPC values at 30 and 60 min were higher, but not significantly, 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 < 0.05). Conclusion: Early postoperative gastric administration of nutritients after CABG surgery stimulates gastric emptying.

early postoperative enteral nutrition ; gastric emptying

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