Effects of early nutritional support in patients with abdominal trauma.

A randomized study was initiated to assess the benefit of early nutritional support in patients with abdominal trauma. To date 18 patients (8 control, 10 enterally fed) have been entered in this study. The controls underwent conventional nutritional treatment. The enterally fed group received constant infusion of a defined diet by needle catheter jejunostomy. The infusion of nutritional support was started at 12 hours postoperatively reaching 3000 kcal/day (1 kcal/min) within 72 hours. After 7 days of treatment the nutritional assessment in the enterally fed group was the following: serum albumin 3.47 +/- 15 to 3.54 +/- 0.10 g%; transferrin 219 +/- 8 to 233 +/- 11 mg%; nitrogen balance -7.8 to + 2.9 g/day. Septic complications occurred in 10% (1/10) of patients. The control group gave the following results: negative nitrogen balance (-10.9 to -6.5 g/day); decreased serum albumin (3.44 +/- 0.1 to 3.22 +/- 0.1 g%) and transferrin levels (215 +/- 9 to 208 +/- 10 mg%). Septic complications occurred in 25% (2/8) of patients. These data suggest: a) early nutritional support decreases the incidence of septic complications and improves the value of nutritional markers in patients with abdominal trauma; b) nutritional infusion by catheter jejunostomy might be safely started at 12 hours postoperatively.