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[The time for beginning of enteral nutrition in traumatic shock]
Hui-qing Rao1, Bei-xi Mo, Dun-rong Zhou
1Intensive Care Unit, People's Hospital of Yangjiang City, Yangjiang 529500, Guangdong, China.
Insights
Monitoring gastric mucosal partial pressure of carbon dioxide (PiCO2) helps determine the optimal timing for enteral nutrition (EN) in traumatic shock patients. This approach improves recovery and survival rates.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Surgical Oncology
Context:
- Traumatic shock patients often require nutritional support.
- Enteral nutrition (EN) is crucial for recovery.
- Timing of EN initiation is critical for outcomes.
Purpose:
- To evaluate the clinical value of monitoring gastric mucosal partial pressure of carbon dioxide (PiCO2) for guiding EN in traumatic shock.
- To compare outcomes between early EN and PiCO2-guided EN.
Summary:
- Ninety-six traumatic shock patients were randomized into two groups: early EN (control) and PiCO2-guided EN (test).
- The test group initiated EN when PiCO2 normalized and symptoms improved.
- Outcomes including recovery, gastrointestinal symptoms, and complications were compared.
Impact:
- PiCO2 monitoring aids in optimizing EN timing for traumatic shock patients.
- This strategy significantly increases cure rates (91.3% vs. 75.0%) and reduces hospital stay (6.0 vs. 7.5 days).
- Early and appropriate EN support enhances intestinal function recovery and survival rates.
Objective:
To explore the value of monitoring CO(2) partial pressure of gastric mucosa (PiCO(2)) in patients with traumatic shock under enteral nutrition (EN) support.
Methods:
Ninety-six patients who were clinically diagnosed as having traumatic shock were randomly divided into two groups: the test group and the control group. In the test group, EN was given after tissue oxygenation, indicated by the value of PiCO(2), approached normal and the clinical symptoms ameliorated. In control group EN was given at the early stage of recovery from shock. The course of convalescence of the primary disease, gastro-intestinal symptoms, the monitoring indexes, and the complications etc. were compared between the two groups.
Results:
Acute physiology and chronic health evaluation II (APACHE II) scores were both gradually lowered in both groups. It was more significant in the control group than that in the test group 5 days later (both P<0.01). Compared with the control group, the cure rate in the test group was increased obviously (91.3% vs. 75.0%, P<0.01), and the hospital stay days were significantly less [(6.0+/-1.8) days vs. (7.5+/-2.3) days, P<0.01].
Conclusion:
It is very important to choose the suitable time to give EN support in patients with traumatic shock, for it can protect and promote the recovery of the function of their intestinal tract, raise the survival rate.
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