[Total parenteral nutrition support for patients with major abdominal trauma]

Thirty-two patients with major abdominal trauma were studied to evaluate the effects of total parenteral nutrition (TPN). There were 24 men and 8 women with average age of 31 years. Twenty-five cases of the group were recorded to have blunt trauma. Abdominal trauma index (ATI) was used to score the injury severity. Sixty-eight percent (22/32) of the patients had more than 15 of ATI and 25% (8/32) had the score over 25. TPN was given to 11 patients with complicated injuries of pancreas and duodenum, to 15 patients with small bowel fistula secondary to extended intestinal trauma, and to 6 patients with severe intraabdominal abscesses after injuries. The average period of TPN support was 26 days. Nutrients were perfused with 32-42 kcal/kg/d of nonprotein energy and 0.21-0.30g/kg/d of nitrogen. The results demonstrated that there were no changes in body weights. Weekly accumulative nitrogen balances increased significantly after the use of TPN. There were great increases of serum albumin, prealbumin, fibronectin and transferrin following TPN support. Blood sugar, cholesterol and triglyceride were in normal ranges. No TPN-related complication developed. All patients recovered uneventfully. It is concluded that the appropriate use of total parenteral nutrition can play an effective role in the treatment of severe abdominal traumatic patients.