Comparing the Consequences of Early and Late Gastric Nutrition in Trauma Patients under Mechanical Ventilation in the Intensive Care Unit: A Prospective Cohort Study

Document Type : Original Research

Authors

1 Department of Emergency and Critical Care Nursing, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran

2 Department of Anesthesiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran

Abstract

Background and Aim: One of the major challenges in feeding intensive care patients is the appropriate time to start gastrointestinal nutrition. This study aimed to compare the consequences of early and late gastric nutrition in trauma patients under mechanical ventilation in the intensive care unit.
Methods: This prospective cohort study was conducted in Zanjan in 2020-2021. In this research, 78 mechanically ventilated trauma patients were selected by convenience sampling. Patients were divided into early and late gastrointestinal nutrition groups according to their feeding time. In these patients, outcome variables, residual gastric volume (within five days), aspiration pneumonia (first, third, and fifth days), and laboratory nutritional indices (first, third, fifth, and tenth) were assessed. Data were analyzed by SPSS v.22 software at the significance level of 0.05.
Results: The results of repeated measures ANOVA showed that the gastric residual volume in the early gastrointestinal nutrition group (0) was significantly lower than in the late gastrointestinal nutrition group (11.42±32.28; P<0.001). The pneumonia aspiration with Cochran's Q test did not show a statistically significant difference between the two groups (P<0.05). In addition, comparing the laboratory indicators with repeated measures ANOVA showed that total protein and calcium in the late gastrointestinal nutrition group showed a statistically significant increase. As well, phosphorus, magnesium, and lymphocyte showed a statistically significant increase in the early gastrointestinal nutrition group (P<0.05). However, these indicators did not show clinically significant differences between the two groups. The stepwise multiple regression model results showed the role of disease severity in predicting the laboratory indicators of total protein, calcium, lymphocyte, and phosphorus. Furthermore, consciousness level played a role in predicting the magnesium index.
Conclusion: Regarding the effect of early feeding on the remaining volume of the stomach, it is recommended to start early feeding in trauma patients.

Keywords


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