Early postoperative gastric enteral nutrition improve gastric emptying after cardiac surgery

Postoperative intragastric enteral feeding in cardiac surgery patients is frequently complicated by delayed gastric emptying. The aim of the study was to evaluate how early postoperative gastric enteral nutrition affects the gastric emptying in coronary artery by-pass graft (CABG) surgery patients. In the prospective, randomized study 40 patients treated at intensive care unit after CABG surgery were studied. Patients were divided in two groups: enteral feeding group E (20 patients: age 59±8 yr.; male 70%) and control group C (20 patients: age 58±10 yr.; male 80%), respectively. Paracetamol absorption test was used to evaluate gastric emptying. In the group E postoperative gastric supply of enteral formula begun 18 hours after surgery and after 6 hours the supply was stopped and paracetamol solution was administrated by nasogastric tube. The patients in group C for.rst 24 hours received only crystalloid solutions intravenously and paracetamol solution by nasogastric tube. Blood samples were obtained at 0 (t₀), 15 (t₊₁₅), 30 (t₊₃₀), 60 (t₊₆₀) and 120 (t₊₁₂₀) min after administration of paracetamol. The values of plasma paracetamol concentration (PPC) at 15 and 120 min were significantly higher in group E vs. group C: (t₊₁₅) 3.3_±2.5 vs. 1.7±1.9 and (t₊₁₂₀) 5.2_−2.8 vs. 3.3_±1.6 (p <0.05). The PPC values at 30 and 60 min were higher, but not signi.cantly, in group E vs. group C: (t₊₃₀) 3.7±2.0 vs. 2.9±2.7 and (t₊₆₀) 5.1±3.2 vs. 3.9±3.5 (p = NS). The area under the PPC curve was 429 ± 309 in the E group vs. 293 ± 204 in the group C (p < 0.05). In conclusion an early postoperative gastric administration of nutritients after CABG surgery stimulates the gastric emptying.