Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial
Introduction: Enteral nutrition is the mainstay of nutritional support in surgical patients. Ileus is the temporary inhibition of peristalsis. Primary post-operative ileus (PPI) occurs postoperatively; thence patients are traditionally kept on nil per oris (NPO) until PPI resolves, due to safety con...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-04-01
|
| Series: | Journal of Pediatric Surgery Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949711624000054 |
| _version_ | 1797341479325138944 |
|---|---|
| author | N.T. Abdulraheem A.A. Nasir L.O. AbdurRahman A.O. Oyinloye M.A. Alada M.O. Olanrewaju D.C. Nwosu J.O. Adeniran |
| author_facet | N.T. Abdulraheem A.A. Nasir L.O. AbdurRahman A.O. Oyinloye M.A. Alada M.O. Olanrewaju D.C. Nwosu J.O. Adeniran |
| author_sort | N.T. Abdulraheem |
| collection | DOAJ |
| description | Introduction: Enteral nutrition is the mainstay of nutritional support in surgical patients. Ileus is the temporary inhibition of peristalsis. Primary post-operative ileus (PPI) occurs postoperatively; thence patients are traditionally kept on nil per oris (NPO) until PPI resolves, due to safety concerns. This study aims to determine the necessity or otherwise of this practice in paediatric surgical patients. Materials and methods: A prospective, randomized control trial, in patients younger than 15 years. The early feeding group (EFG) commenced enteral feeding on the first post-operative day while controls commenced feeding after resolution of PPI. Data was analyzed using SPSS version 20.0, P ≤ 0.05 was regarded as significant. The primary outcome was tolerability of enteral feeds while secondary outcomes were complication rates, time to full enteral diet, and duration of hospital stay. Results: There were 56 patients, 28 in each study group. Tolerability of oral feeds at initial commencement was similar in both groups (24 (85.7%) EFG versus 27 (96.4%) controls P = 0.16). Full enteral feeding was achieved faster in EFG than in controls (71.1 ± 28.7 hours versus 92.5 ± 31.4 hours, p=0.011). Post-operative hospital stay was shorter in EFG than controls (7.46 ± 3.8 days versus11.1 ± 5.2 days, p=0.009). Conclusions: Early enteral feeding was well tolerated, brought about a faster return to a full enteral diet, and shorter post-operative hospital stay, it also did not cause a higher complication rate. Therefore, delaying feeding until the resolution of PPI after laparotomy appears unnecessary. |
| first_indexed | 2024-03-08T10:18:57Z |
| format | Article |
| id | doaj.art-98517bf4f3d247269a57d0a46d597aa8 |
| institution | Directory Open Access Journal |
| issn | 2949-7116 |
| language | English |
| last_indexed | 2024-03-08T10:18:57Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Open |
| spelling | doaj.art-98517bf4f3d247269a57d0a46d597aa82024-01-28T04:22:09ZengElsevierJournal of Pediatric Surgery Open2949-71162024-04-016100120Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trialN.T. Abdulraheem0A.A. Nasir1L.O. AbdurRahman2A.O. Oyinloye3M.A. Alada4M.O. Olanrewaju5D.C. Nwosu6J.O. Adeniran7Division of Paediatric Surgery, Department of Surgery, University of Ilorin Teaching Hospital, and College of Health Sciences, University of Ilorin, Ilorin, Nigeria; Corresponding author at: Division of Paediatrics Surgery, Department of Surgery, University of Ilorin Teaching Hospital, PMB 1459, Ilorin, Nigeria.Division of Paediatric Surgery, Department of Surgery, University of Ilorin Teaching Hospital, and College of Health Sciences, University of Ilorin, Ilorin, NigeriaDivision of Paediatric Surgery, Department of Surgery, University of Ilorin Teaching Hospital, and College of Health Sciences, University of Ilorin, Ilorin, NigeriaDivision of Paediatric Surgery, Department of Surgery, Modibo Adama University Teaching Hospital, Yola, Adamawa State, NigeriaDepartment of Surgery, Asokoro Distric Hospital, and Nile University, Abuja, NigeriaPaediatric Surgery unit, Department of Surgery, Federal Medical Centre, Abeokuta, NigeriaSurgery Department, George Elliot Hospital, Nuneaton, UKDepartment of Surgery, Bowen University Teaching Hospital, Ogbomoso, Oyo state, NigeriaIntroduction: Enteral nutrition is the mainstay of nutritional support in surgical patients. Ileus is the temporary inhibition of peristalsis. Primary post-operative ileus (PPI) occurs postoperatively; thence patients are traditionally kept on nil per oris (NPO) until PPI resolves, due to safety concerns. This study aims to determine the necessity or otherwise of this practice in paediatric surgical patients. Materials and methods: A prospective, randomized control trial, in patients younger than 15 years. The early feeding group (EFG) commenced enteral feeding on the first post-operative day while controls commenced feeding after resolution of PPI. Data was analyzed using SPSS version 20.0, P ≤ 0.05 was regarded as significant. The primary outcome was tolerability of enteral feeds while secondary outcomes were complication rates, time to full enteral diet, and duration of hospital stay. Results: There were 56 patients, 28 in each study group. Tolerability of oral feeds at initial commencement was similar in both groups (24 (85.7%) EFG versus 27 (96.4%) controls P = 0.16). Full enteral feeding was achieved faster in EFG than in controls (71.1 ± 28.7 hours versus 92.5 ± 31.4 hours, p=0.011). Post-operative hospital stay was shorter in EFG than controls (7.46 ± 3.8 days versus11.1 ± 5.2 days, p=0.009). Conclusions: Early enteral feeding was well tolerated, brought about a faster return to a full enteral diet, and shorter post-operative hospital stay, it also did not cause a higher complication rate. Therefore, delaying feeding until the resolution of PPI after laparotomy appears unnecessary.http://www.sciencedirect.com/science/article/pii/S2949711624000054Enteral feedingBowel soundsLaparotomyIleus |
| spellingShingle | N.T. Abdulraheem A.A. Nasir L.O. AbdurRahman A.O. Oyinloye M.A. Alada M.O. Olanrewaju D.C. Nwosu J.O. Adeniran Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial Journal of Pediatric Surgery Open Enteral feeding Bowel sounds Laparotomy Ileus |
| title | Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial |
| title_full | Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial |
| title_fullStr | Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial |
| title_full_unstemmed | Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial |
| title_short | Is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy? A randomized control trial |
| title_sort | is the restoration of bowel sounds a prerequisite for initiating enteral feeding following pediatric laparotomy a randomized control trial |
| topic | Enteral feeding Bowel sounds Laparotomy Ileus |
| url | http://www.sciencedirect.com/science/article/pii/S2949711624000054 |
| work_keys_str_mv | AT ntabdulraheem istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT aanasir istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT loabdurrahman istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT aooyinloye istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT maalada istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT moolanrewaju istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT dcnwosu istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial AT joadeniran istherestorationofbowelsoundsaprerequisiteforinitiatingenteralfeedingfollowingpediatriclaparotomyarandomizedcontroltrial |