Introduction: Patients with abdominal surgical pathology always have gastrointestinal failure. Under such conditions, the enteral administration of nutrients may be started by trophic nutrition; however, starting nutritional mixtures for it have not been clearly defined. The aim of this study was optimization of energetic and plastic supply of patients with abdominal surgical pathology by studying the efficacy of the clinical nutrition means.
Materials and methods: An observational analytical observational prospective case-control study of clinical nutrition efficacy has been conducted in 112 patients aged 18 to 45, who underwent intencive care after urgent abdominal surgical interventions. The patients were divided into two groups: in the treatment group (n=64), trophic nutrition by a semi-elemental nutritional formula was initiated within 12 hours after completion of surgery, and in the control group (n=48), the conventional clinical nutrition tactics was used. The levels of serum albumin, glycosaminoglycans, alkaline phosphatase and urine diastase activities were assessed; the lengths of patients' stay in the intensive care unit was recorded.
Results and conclusions: The application of early enteral nutrition in the regimen of trophic nutrition with the use of a semi-elemental nutritional formula allowed to improve protein provision (serum albumin level - 38.68±1.55 g/l vs 32.04±1.5 g/l) (?<0.05), to decrease the functional load on the cytoprotective system of the gastrointestinal mucosa (level of glycosaminoglycans 0.11±0.079 g/l vs 0.181±0.113) (?<0.05), to decrease the severity of cholestasis (alkaline phosphatase activity 620.6± 6.22 nmol/s/l vs 723±7.2 nmol/s/l (?<0.05), to achieve relative functional rest of the pancreas (44.5±1.7 g/(h x l) vs 62.6±2.1 g/(h x l)) (?<0.05) and allowed to decrease the length of patients' stay in the intensive care unit (115.9±2.69 hours vs 130.8±3.06 hours) (?<0.05).
Keywords: abdominal surgery; clinical nutrition; intencive care; semi-elemental formulae.