Enteral feeding can be safe up to time of surgery in some trauma patients

מתוך medicontext.co.il
By Joene Hendry

SAN DIEGO, California (Reuters Health) – Enteral feeding can safely be continued in critically ill trauma patients right up to the time of surgery, rather than having these patients undergo a period of NPO for as long as 1 day before surgery, Dr. Maureen McCunn, of the University of Maryland Shock Trauma Center in Baltimore, reported at a meeting here on Sunday.

Dr. McCunn and colleagues are conducting an ongoing study to determine the value of continuing pre-operative enteral feeding in trauma patients. During poster presentations at the Society for Critical Care Medicine's 31st Critical Care Congress, data for 14 patients were presented. The findings revealed no evidence of aspiration and no postoperative pneumonia consistent with aspiration, risks traditionally associated with continued pre-operative feeding.

Six of the patients, who were on mechanical ventilation, had jejunal feedings continued until transport to the operating room. In the remaining eight patients, gastric feeding was continued if the patients were undergoing a peripheral procedure. All feeding solutions were colored with a blue dye to permit identification through the suctioning of gastric contents during surgery.

The findings show, "it is safe to continue feedings pre-operatively," Dr. McCunn told Reuters Health. "We had no identified complications," she added.

Daily caloric needs were met in 29% of patients receiving gastric feedings and in 59% of those on jejunal feedings. Dr. McCunn pointed out that when enteral feeding is stopped pre-operatively, the patients receive none or very little of their daily caloric needs.

Additional caloric intake, the investigators note, may lead to improved nutritional status and wound healing and a decrease in infectious complications after surgery. Dr. McCunn's group is continuing their analysis of continued pre-operative enteral feedings. They now have more than 40 patients in their study cohort.

"Although microaspiration may be more common with gastric feeds, we saw no evidence of this grossly or clinically," the researchers noted in their presentation

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