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Impact of early high caloric duodenal feeding on the oxygen balance of the splanchnic region after severe burn injury
Authors:Andel H  Rab M  Andel D  Felfernig M  Hörauf K  Felfernig D  Schramm W  Zimpfer M
Institution:Department of Anesthesiology and Intensive Care, Vienna Medical School, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. h.andel@akh-wien.ac.at
Abstract:Early enteral nutrition is recommended in burned patients. Depending on the amount administered, enteral feeding causes an increase of intestinal oxygen-demand. Although early moderate enteral nutrition has been shown to be beneficial, early high calorie enteral nutrition might lead to an imbalance of the O(2)-balance of the gut since intestinal perfusion is decreased after major burns. In 20 severely burned patients during the first 48 h of early high caloric duodenal feeding an assessment of the CO(2)-gap between the arterial and the gastric CO(2), as parameter for the intestinal O(2)-balance, was performed. Time points were prior to starting the enteral nutrition (BASE) subsequently every 30 min after increasing the amount of nutrition administered and from the 11th to the 48th h after beginning of nutrition in intervals of 6 h. In none of the patients was the CO(2)-gap increased during the rapid increase of enteral nutrition. On the contrary the CO(2)-gap decreased significantly. We conclude that high caloric duodenal feeding in the early hypodynamic postburn phase does not have adverse effects on the oxygen balance of the intestine.
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