Department of Hepatology and Gastroenterology, Aarhus University Hospital, DK-8200, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958, Denmark.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, DK-8200, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958, Denmark; Department of Biomedicine, Aarhus University, DK-8000, Denmark.
Clin Nutr. 2019 Oct;38(5):2079-2086. doi: 10.1016/j.clnu.2018.10.014. Epub 2018 Oct 24.
Patients with an ileostomy often experience fluid and electrolyte depletion because of gastrointestinal loss. This study aimed to compare how an iso-osmolar and a hyperosmolar oral supplement affect ileostomy output, urine production, and natriuresis as proxy measurements of water-electrolyte balance.
In a randomised, double-blinded, active comparator, crossover intervention study, we included eight adult ileostomy patients who were independent of parenteral support. We investigated how an iso-osmolar (279 mOsm/kg) and a hyperosmolar (681 mOsm/kg) oral supplement affected ileostomy output mass, urine volume, and natriuresis. In addition to their habitual diet, each participant ingested 800 mL/day of either the iso-osmolar or hyperosmolar supplement in each of two study periods. Each period started with 24-hour baseline measurements, and the supplements were ingested during the following 48 h. All measurements were repeated in the last 24 h.
No statistically significant changes in ileostomy output were detected following the intake of either oral supplement (median (range) 67 (-728 to 290) g/day, p = 0.25) despite increased fluid intake. Compared with the hyperosmolar supplement, the iso-osmolar supplement induced a statistically significant increase in urine volume (470 (0-780) mL/day, p = 0.02) and natriuresis (36 (0-66) mmol/day, p = 0.02).
Intake of the two oral supplements did not affect ileostomy output during this short intervention. Natriuresis increased following intake of the iso-osmolar supplement compared to that after ingesting the hyperosmolar supplement, indicating that patients with an ileostomy may benefit from increasing their ingestion of iso-osmolar fluids. ClinicalTrials.gov identifier:NCT03348709.
由于胃肠道流失，回肠造口术患者常出现液体和电解质耗竭。本研究旨在比较等渗和高渗口服补充剂如何影响回肠造口术的输出、尿液产生和尿钠排泄，作为水-电解质平衡的替代测量指标。
在一项随机、双盲、阳性对照的交叉干预研究中，我们纳入了 8 名独立于肠外支持的成年回肠造口术患者。我们研究了等渗（279 mOsm/kg）和高渗（681 mOsm/kg）口服补充剂如何影响回肠造口术的输出量、尿量和尿钠排泄。除了他们的习惯性饮食外，每位参与者在两个研究期内每天摄入 800 mL 的等渗或高渗补充剂。每个时期都以 24 小时的基线测量开始，在接下来的 48 小时内摄入补充剂。所有测量都在最后 24 小时内重复。
尽管液体摄入量增加，但两种口服补充剂的摄入均未检测到回肠造口术输出的统计学显著变化（中位数（范围）67（-728 至 290）g/天，p=0.25）。与高渗补充剂相比，等渗补充剂可使尿量（470（0-780）mL/天，p=0.02）和尿钠排泄量（36（0-66）mmol/天，p=0.02）显著增加。
在这项短期干预中，两种口服补充剂的摄入均未影响回肠造口术的输出。与摄入高渗补充剂相比，摄入等渗补充剂后尿钠排泄增加，表明回肠造口术患者可能受益于增加摄入等渗液体。临床试验注册编号：NCT03348709。
