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Early nasoduodenal feeding for the post-biliary surgical patient
T L Hwang1, S L Huang, M F Chen
1Nutritional Support Service, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Early nasoduodenal feeding after biliary surgery improves patient outcomes. Patients receiving early nutrition showed better nitrogen balance, increased visceral protein, and higher lymphocyte counts compared to those fed later.
Area of Science:
- Surgical Nutrition
- Gastroenterology
- Metabolic Response
Background:
- Postoperative nutritional support is crucial for recovery.
- Timely initiation of feeding impacts metabolic and nutritional status.
- Biliary surgery patients often require specialized nutritional management.
Purpose of the Study:
- To evaluate the effects of early postoperative nasoduodenal feeding on nutritional and metabolic parameters in patients undergoing biliary surgery.
- To compare outcomes between patients receiving early enteral nutrition and those with delayed feeding.
Main Methods:
- A randomized controlled trial involving 24 patients after biliary surgery.
- Two groups: early nasoduodenal feeding (Group I) from day 1 vs. delayed feeding (Group II) from day 4.
- Nutritional status, nitrogen balance, serum albumin, transferrin, prealbumin, and total lymphocyte count were monitored over one week.
Main Results:
- Early feeding significantly reduced negative nitrogen balance (-1.91 g/day vs -5.84 g/day).
- Improved serum prealbumin levels and total lymphocyte counts were observed in the early feeding group.
- Patients receiving early nasoduodenal feeding reported feeling better overall.
Conclusions:
- Early nasoduodenal feeding post-biliary surgery enhances nitrogen balance.
- Initiating enteral nutrition early accelerates the increase in short half-life visceral proteins and total lymphocyte count.
- Early feeding is associated with improved clinical well-being and metabolic recovery in these patients.
Abstract:
The effects of early postoperative nasoduodenal feeding on nutrition and metabolic response were studied using 24 patients after biliary surgery. The patients were randomly divided into two groups with 12 in each group. Group I was fed via a nasoduodenal tube from the first postoperative day but control group II was not fed until the fourth postoperative day. The hospital blenderized tube feeding diet provided the enteric nutrition (17% protein, 33% fat and 50% carbohydrate). The nutritional status of the 2 groups was compared over a one week period. The changes in nitrogen balance were measured daily for 8 days. The group fed early had a significantly reduced negative nitrogen balance when compared to the group whose feeding was started later. (-1.91 +/- 1.05 g/day vs -5.84 +/- 0.48 g/day). There was no difference in serum albumin and transferrin levels, but serum prealbumin levels in the group fed early were more desirable than those of the control group (from 15.8 +/- 2.5 mg/dl to 28.9 +/- 3.8 mg/dl vs from 18.0 +/- 2.0 mg/dl to 25.9 +/- 3.9 mg/dl). Total lymphocyte count was also better in the group fed early than in the controls (from 1,325 +/- 204 cells/mm3 to 2,655 +/- 584 cells/mm3 vs from 1,277 +/- 188 cells/mm3 to 1,877 +/- 440 cells/mm3). All the patients in group I felt better than those in group II during the study course. These results indicated that those patients provided with early nasoduodenal feeding after a biliary operation displayed a better nitrogen balance, and a faster increase in short half life visceral protein and total lymphocyte count.