Scientific papersPostinjury abdominal compartment syndrome does not preclude early enteral feeding after definitive closure
Section snippets
Materials and methods
Denver Health Medical Center (DHMC) is a state-certified and American College of Surgeons–verified level-I regional trauma center and integral teaching facility of the University of Colorado Health Sciences Center. Patients undergoing decompressive laparotomy for ACS from January 1996 to August 2003 were identified using our trauma registry database and operative records, and subsequently reviewed. ACS was defined as intra-abdominal hypertension >25 mmHg as measured by urinary bladder pressure
Results
During the study period, 16,662 patients were admitted to the hospital after traumatic injury; 2,762 patients were admitted to the surgical intensive care unit with an injury severity score >15. Thirty-seven patients developed postinjury ACS requiring operative decompression during the 7.5 year study period; 26 men and 11 women had a mean age of 36 ± 4 and a mean injury severity score of 33 ± 4. Twenty-eight of these patients (76%) suffered blunt trauma. Mean intra-abdominal pressure (urinary
Comments
The physiologic benefits of enteral nutrition are widely recognized. Multiple studies have shown decreased septic complications, prevention of gut mucosal atrophy, preservation of normal flora, and attenuation of the hypermetabolic postinjury response with TEN [8], [9], [10], [11], [12], [13]. In our clinical studies, septic complications in postoperative patients, notably intra-abdominal abscess and pneumonia, were only 18% in patients given early TEN versus 35% in those administered total
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