Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma
Abstract Background In patients with blunt injury due to abdominal trauma, the common cause for laparotomy is damage to the small bowel and mesentery. Recently, postoperative early enteral nutrition (EEN) has been recommended for abdominal surgery. However, EEN in patients with blunt bowel and/or me...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-01955-2 |
| _version_ | 1797860046957182976 |
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| author | Hyunseok Jang Sangyun An Naa Lee Euisung Jeong Yunchul Park Jungchul Kim Younggoun Jo |
| author_facet | Hyunseok Jang Sangyun An Naa Lee Euisung Jeong Yunchul Park Jungchul Kim Younggoun Jo |
| author_sort | Hyunseok Jang |
| collection | DOAJ |
| description | Abstract Background In patients with blunt injury due to abdominal trauma, the common cause for laparotomy is damage to the small bowel and mesentery. Recently, postoperative early enteral nutrition (EEN) has been recommended for abdominal surgery. However, EEN in patients with blunt bowel and/or mesenteric injury (BBMI) has not been established. Therefore, this study aimed to identify the factors that affect early postoperative small bowel obstruction (EPSBO) and the date of tolerance to solid food and defecation (SF + D) after surgery in patients with BBMI. Methods We retrospectively reviewed patients who underwent laparotomy for BBMI at a single regional trauma center between January 2013 and July 2021. A total of 257 patients were included to analyze the factors associated with enteral nutrition tolerance in patients with EPSBO and the postoperative day of tolerance to SF + D. Results The incidence of EPSBO in patients with BBMI was affected by male sex, small bowel organ injury scale (OIS) score, mesentery OIS score, amount of crystalloid, blood transfusion, and postoperative drain removal date. The higher the mesentery OIS score, the higher was the EPSBO incidence, whereas the small bowel OIS did not increase the incidence of EPSBO. The amount of crystalloid infused within 24 h; the amount of packed red blood cells, fresh frozen plasma, and platelet concentrate transfused; the time of drain removal; Injury Severity Score; and extremity abbreviated injury scale (AIS) score were correlated with the day of tolerance to SF + D. Multivariate analysis between the EPSBO and non-EPSBO groups identified mesentery and small bowel OIS scores as the factors related to EPSBO. Conclusion Mesenteric injury has a greater impact on EPSBO than small bowel injury. Further research is needed to determine whether the mesentery OIS score should be considered during EEN in patients with BBMI. The amount of crystalloid infused and transfused blood components within 24 h, time of drain removal, injury severity score, and extremity AIS score are related to the postoperative day on which patients can tolerate SF + D. |
| first_indexed | 2024-04-09T21:39:24Z |
| format | Article |
| id | doaj.art-bef41c0bb8da4366b2b1ea845f6545c2 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-09T21:39:24Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-bef41c0bb8da4366b2b1ea845f6545c22023-03-26T11:05:45ZengBMCBMC Surgery1471-24822023-03-0123111010.1186/s12893-023-01955-2Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt traumaHyunseok Jang0Sangyun An1Naa Lee2Euisung Jeong3Yunchul Park4Jungchul Kim5Younggoun Jo6Division of Trauma, Department of Surgery, Chonnam National University Medical School and HospitalDepartment of Surgery, Chonnam National University Medical School and HospitalDivision of Trauma, Department of Surgery, Chonnam National University Medical School and HospitalDivision of Trauma, Department of Surgery, Chonnam National University Medical School and HospitalDivision of Trauma, Department of Surgery, Chonnam National University Medical School and HospitalDivision of Trauma, Department of Surgery, Chonnam National University Medical School and HospitalDivision of Trauma, Department of Surgery, Chonnam National University Medical School and HospitalAbstract Background In patients with blunt injury due to abdominal trauma, the common cause for laparotomy is damage to the small bowel and mesentery. Recently, postoperative early enteral nutrition (EEN) has been recommended for abdominal surgery. However, EEN in patients with blunt bowel and/or mesenteric injury (BBMI) has not been established. Therefore, this study aimed to identify the factors that affect early postoperative small bowel obstruction (EPSBO) and the date of tolerance to solid food and defecation (SF + D) after surgery in patients with BBMI. Methods We retrospectively reviewed patients who underwent laparotomy for BBMI at a single regional trauma center between January 2013 and July 2021. A total of 257 patients were included to analyze the factors associated with enteral nutrition tolerance in patients with EPSBO and the postoperative day of tolerance to SF + D. Results The incidence of EPSBO in patients with BBMI was affected by male sex, small bowel organ injury scale (OIS) score, mesentery OIS score, amount of crystalloid, blood transfusion, and postoperative drain removal date. The higher the mesentery OIS score, the higher was the EPSBO incidence, whereas the small bowel OIS did not increase the incidence of EPSBO. The amount of crystalloid infused within 24 h; the amount of packed red blood cells, fresh frozen plasma, and platelet concentrate transfused; the time of drain removal; Injury Severity Score; and extremity abbreviated injury scale (AIS) score were correlated with the day of tolerance to SF + D. Multivariate analysis between the EPSBO and non-EPSBO groups identified mesentery and small bowel OIS scores as the factors related to EPSBO. Conclusion Mesenteric injury has a greater impact on EPSBO than small bowel injury. Further research is needed to determine whether the mesentery OIS score should be considered during EEN in patients with BBMI. The amount of crystalloid infused and transfused blood components within 24 h, time of drain removal, injury severity score, and extremity AIS score are related to the postoperative day on which patients can tolerate SF + D.https://doi.org/10.1186/s12893-023-01955-2Enteral nutritionMutiple trauma, laparotomyIleusIntestine, small |
| spellingShingle | Hyunseok Jang Sangyun An Naa Lee Euisung Jeong Yunchul Park Jungchul Kim Younggoun Jo Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma BMC Surgery Enteral nutrition Mutiple trauma, laparotomy Ileus Intestine, small |
| title | Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma |
| title_full | Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma |
| title_fullStr | Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma |
| title_full_unstemmed | Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma |
| title_short | Factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma |
| title_sort | factors associated with enteral nutrition tolerance after trauma laparotomy of the small bowel and mesenteric injuries by blunt trauma |
| topic | Enteral nutrition Mutiple trauma, laparotomy Ileus Intestine, small |
| url | https://doi.org/10.1186/s12893-023-01955-2 |
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