Immediate jejunostomy feeding. Its use after major abdominal trauma

Area of Science:

• Trauma Surgery
• Surgical Nutrition
• Gastrointestinal Surgery

Background:

• Massive abdominal and retroperitoneal injuries necessitate prompt nutritional intervention.
• Optimal timing and methods for postoperative feeding in trauma patients remain critical areas of study.

Purpose of the Study:

• To evaluate the safety and efficacy of early jejunostomy feedings in patients with severe abdominal and retroperitoneal trauma.
• To assess the impact of needle-catheter jejunostomy on nutritional status and specific injury types.

Main Methods:

• A prospective study of 30 patients with multiple visceral injuries receiving early jejunostomy feedings (Vivonex HN) starting 18 hours postoperatively.
• Nutritional support delivered via a 16-gauge intracatheter in the proximal jejunum, reaching 2,400 calories/day within 72 hours.
• Monitoring of serum albumin, transferrin, total lymphocyte count, and delayed hypersensitivity.

Main Results:

• Jejunal feedings were maintained for an average of eight days, with nutritional markers remaining stable or improving.
• Patients with pancreatic injuries tolerated supplemental nutrition without increased pancreatic stimulation.
• The technique proved safe and effective in providing early nutritional support across various trauma types (blunt, gunshot, stab).

Conclusions:

• Needle-catheter jejunostomy is a viable and safe method for early nutritional support following major abdominal trauma.
• Early jejunal feeding can maintain nutritional status in critically injured patients.
• Further research is warranted to identify specific patient subgroups who would most benefit from this early feeding strategy.