title: Nutritional support: a prophylaxis against stress bleeding after spinal cord injury.
abstract: The incidence of upper gastrointestinal (UGI) bleeding and the effect of nutritional support was studied retrospectively in 166 spinal cord injured patients. Sixty six patients included in group 1 were started on oral diet when 'clinically ready' which resulted in a haphazard manner for provision of nutrition. One hundred patients in group 2 were treated according to an organised nutrition protocol. The protocol initiates total parental nutrition (TPN) if the patient is not tolerating an oral diet by day 5. All group 2 patients met their total energy requirements (TER) within 48 hours after initiating caloric supplementation. The overall incidence of acute acid peptic ulceration leading to significant bleeding or perforation was 4%. Five of the 66 group 1 patients (7.5%) and 2 of the 100 group 2 patients (2%) developed acute ulcerations. While the exact mechanism remains unclear, this significant (p less than 0.05) reduction indicates that a nutritional regimen that meets a patients TER decreases the likelihood of acid peptic complications after spinal cord injury.
authors.affiliation: Department of Surgery and Orthopedic Surgery, Wayne State University, Detroit, Michigan.
authors.forename: J
authors.initials: J
authors.lastname: Kuric
authors.forename: C E
authors.initials: CE
authors.lastname: Lucas
authors.forename: A M
authors.initials: AM
authors.lastname: Ledgerwood
authors.forename: A
authors.initials: A
authors.lastname: Kiraly
authors.forename: G G
authors.initials: GG
authors.lastname: Salciccioli
authors.forename: C
authors.initials: C
authors.lastname: Sugawa
mesh_terms: D000328:Adult; D005260:Female; D005744:Gastric Acid; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009666:Nose; D010289:Parenteral Nutrition, Total; D013119:Spinal Cord Injuries / Q000150:complications*; D013276:Stomach Ulcer / Q000150:complications / Q000209:etiology; D013312:Stress, Physiological / Q000150:complications*; D013396:Suction