FEASIBILITY AND COMPLICATIONS OF EARLY EN TERAL NUTRITION IN SEVERELYINJURED PATIENTS VIA NASODUODENAL FEEDING TUBES

Early enteral nutrition is widely accepted for its support of organ st ructure and function (''gut injury hypothesis'') and reduction of infe ctious complications and hypermetabolism in critically ill postoperati ve or postinjury patients. Nineteen severely injured patients (Injury Severity Score 40.3+/-11.6) were studied for the feasibility of early enteral nutrition via a duodenal feeding tube. Despite maxillary fract ures, rhinoliquorrhea and blunt abdominal trauma the enteral feeding w as mostly started immediately after trauma. Intermittent diarrhea or c onstipation resolved after reduction of the feeding rate within 1 or 2 days. Total enteral nutrition could not be realized in all cases; a c entral venous line was always additionally necessary. However, the goa l was not complete enteral nutrition but a continuous enteral supply t o maintain the integrity of the gut. The study has shown that early en teral nutrition via a duodenal feeding tube is also feasible in severe ly injured patients. The expenditure to overcome the technical and org anizational problems seems to be justified. Enterally fed patients may have a better outcome that those in whom only parenteral is employed.