title: Impact of early high caloric duodenal feeding on the oxygen balance of the splanchnic region after severe burn injury.
abstract: Early enteral nutrition is recommended in burned patients. Depending on the amount administered, enteral feeding causes an increase of intestinal oxygen-demand. Although early moderate enteral nutrition has been shown to be beneficial, early high calorie enteral nutrition might lead to an imbalance of the O(2)-balance of the gut since intestinal perfusion is decreased after major burns. In 20 severely burned patients during the first 48 h of early high caloric duodenal feeding an assessment of the CO(2)-gap between the arterial and the gastric CO(2), as parameter for the intestinal O(2)-balance, was performed. Time points were prior to starting the enteral nutrition (BASE) subsequently every 30 min after increasing the amount of nutrition administered and from the 11th to the 48th h after beginning of nutrition in intervals of 6 h. In none of the patients was the CO(2)-gap increased during the rapid increase of enteral nutrition. On the contrary the CO(2)-gap decreased significantly. We conclude that high caloric duodenal feeding in the early hypodynamic postburn phase does not have adverse effects on the oxygen balance of the intestine.
authors.affiliation: Department of Anesthesiology and Intensive Care, Vienna Medical School, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. h.andel@akh-wien.ac.at
authors.forename: H
authors.initials: H
authors.lastname: Andel
authors.forename: M
authors.initials: M
authors.lastname: Rab
authors.forename: D
authors.initials: D
authors.lastname: Andel
authors.forename: M
authors.initials: M
authors.lastname: Felfernig
authors.forename: K
authors.initials: K
authors.lastname: Hörauf
authors.forename: D
authors.initials: D
authors.lastname: Felfernig
authors.forename: W
authors.initials: W
authors.lastname: Schramm
authors.forename: M
authors.initials: M
authors.lastname: Zimpfer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000628:therapy*; D002245:Carbon Dioxide / Q000378:metabolism; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen