[Nutritional support in patients with open abdomen].
OBJECTIVE
We have designed a protocol to evaluate the tolerance, effectiveness and the nutritional support in post-surgical patients with an open abdomen.


METHODS
We have made a prospective descriptive study of patients submitted to surgery and left with an open abdomen with a Bogoti bag, and have received nutritional support. The patients who have stayed for less than 4 days with the open abdomen where excluded. A group received total parenteral nutrition (TPN) with mixtures all in one; another group received enteral nutrition (EN) through a needle catheter jejunostomy (NCJ) and a third group received mixed nutritional support. To evaluate the tolerance to EN, we have included those patients receiving this type of nutrition for at least 4 consecutive days without having diarrhea or pain. A jejunostomy catheter was placed in all patients by need o puncturing during the surgical act.


METHODS
The Surgical Department I of Angel Larralde University Hospital, I.V.S.S. Valencia-Venezuela, during the period from May 2002 to May 2005.


RESULTS
24 patients entered the study, 46% recived mixed nutritional support (Enteral and Parenteral), 33% exclusively TPN, and 31% exclusively EN. 75% have evolved favorably, discharged to their home in good general condition; 25% died from multiple organ failure due to severe sepsis. About nutritional support, 66% of the patients did not present complications; 21% of those receiving TPN presented hyperglycemia; and 13% of those receiving EN presented diarrhea. About EN effectiveness, 69% of the patients have reached 80% of the estimated caloric objective within days 4-5 from the beginning of formula administration.


CONCLUSIONS
The integral care of the patients with an open abdomen, added to a nutritional support regimen tailored to each patient's condition can help decreasing the hypermetabolic response, as well as moridity and mortality.
Velázquez
J O
JO
Cirujano General, MSVC, Venezuela. jvelazquezg@intercable.net.ve
Urbistazu
J P
JP
Vargas
M
M
Guedez
I
I
Cadenas
M
M
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000009:adverse effects; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies