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[Severe gastroesophageal lesions due to caustics: the role of nutritional support]
A Zabalegui1, A Miján de la Torre, F Sáez-Royuela
1Seccion de Aparato Digestivo, Hospital General Yagüe, Burgos, España.
Aim:
Describe the clinical-nutritional state of patients with severe digestive lesions after the ingestion of caustic substances, as well as their nutritional support (NS).
Patients And Methods:
We studied 5 patients diagnosed by means of early endoscopy, treated with artificial nutrition, 4 of whom used enteral nutrition. During the acute phase of the disease, an evaluation of the nutritional state (ENS) was done, by means of the following parameters: body mass index (BMI), creatinine/height index (CHI), visceral proteins, nitrogen content of 24 h urine, and plasma zinc level. The corrected Harris-Benedict equation was used to calculate the energy needs.
Results:
The BMI did not experience significant changes. The CHI decreased in a large degree. The long life visceral protein did not change notably, and those of intermediate and short life increased. The losses of nitrogen were increased. We found hypozincemia in 4 of the cases. The mean Kcal provided was 2323 +/- 105.
Conclusions:
In the described patients, given their catabolic condition, and early ENS and NS should be done. If at all possible, the NS shall be enteral, with or without parenteral support. In our study we have found a cessation of the weight loss, a decrease of somatic protein with a short term re-filling of the visceral protein pol. The zinc levels should be monitored.