Immediate jejunostomy feeding. Its use after major abdominal trauma.

Jejunostomy feedings were used in the immediate postoperative period in patients with massive abdominal and retroperitoneal injuries. Patients were selected for early feeding if they had two or more major visceral injuries. Over a six-month period, 30 such patients were studied: ten had blunt trauma, 11 had gunshot wounds, and nine had stab injuries. The injuries included 11 pancreatic, ten small-bowel, six colon, and six major retroperitoneal vascular injuries. A 16-gauge intracatheter was placed in the proximal jejunum. The constant infusion of nutritional solution (Vivonex HN) was begun 18 hours postoperatively, and within 72 hours all patients were receiving 2,400 calories per day. Feedings were maintained for an average of eight days. Serum albumin and transferrin levels, total lymphocyte count, and delayed hypersensitivity were maintained or improved during jejunal feeding. Patients with pancreatic injuries received supplemental nutrition without evidence of pancreatic stimulation. Needle-catheter jejunostomy can provide early, safe nutritional support after major abdominal trauma. Further investigation is needed to determine who will benefit from this early feeding.

[1]  Keith Rg.  Effect of a low fat elemental diet on pancreatic secretion during pancreatitis. , 1980 .

[2]  J. Fischer,et al.  Studies on calorie to nitrogen ratio for total parenteral nutrition. , 1980, Surgery, gynecology & obstetrics.

[3]  Torosian Mh,et al.  Feeding by tube enterostomy. , 1980 .

[4]  R. Price,et al.  Protein-calorie malnutrition in a community hospital. , 1980, JAMA.

[5]  C. Shield,et al.  Safe, cost-effective postoperative nutrition. Defined formula diet via needle-catheter jejunostomy. , 1979, American journal of surgery.

[6]  G. Hill,et al.  Fine needle catheter jejunostomy—An assessment of a new method of nutritional support after major gastrointestinal surgery , 1979, The British journal of surgery.

[7]  J. Alexander,et al.  A comparison of immunologic profiles and their influence on bacteremia in surgical patients with a high risk of infection. , 1979, Surgery.

[8]  L. Maclean.  Host resistance in surgical patients. , 1979, The Journal of trauma.

[9]  R. Shields,et al.  Early postoperative feeding with elemental diet. , 1979, British medical journal.

[10]  Freeman Jb,et al.  Canine pancreatic exocrine secretory response to low- and high-fat elemental diets. , 1977 .

[11]  G. Blackburn,et al.  Nutritional care of the injured and/or septic patient. , 1976, The Surgical clinics of North America.

[12]  G. Blackburn,et al.  Protein status of general surgical patients. , 1974, JAMA.

[13]  N. Abdou,et al.  The effects of protein calorie malnutrition on immune competence of the surgical patient. , 1974, Surgery, gynecology & obstetrics.

[14]  Allardyce Db,et al.  A comparison of nutritional gains resulting from intravenous and enteral feeding. , 1974 .

[15]  E. Seifter,et al.  Intrajejunal administration of an elemental diet at neutral pH avoids pancreatic stimulation. Studies in dog and man. , 1973, American journal of surgery.

[16]  H. Delany,et al.  Jejunostomy by a needle catheter technique. , 1973, Surgery.

[17]  C. Roda,et al.  Gastrointestinal Motility Studies as a Guide to Postoperative Management , 1972, Annals of surgery.

[18]  M. Winitz,et al.  Studies in metabolic nutrition employing chemically defined diets. I. Extended feeding of normal human adult males. , 1970, The American journal of clinical nutrition.

[19]  D. Wilmore,et al.  Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. , 1968, Surgery.

[20]  Glucksman Dl,et al.  Small intestinal absorption in the immediate postoperative period. , 1966 .

[21]  N. Mcintyre,et al.  Intestinal factors in the control of insulin secretion. , 1965, The Journal of clinical endocrinology and metabolism.

[22]  C WELLS,et al.  POSTOPERATIVE GASTROINTESTINAL MOTILITY. , 1964, Lancet.

[23]  W. Kulke,et al.  Post-operative absorption of water from the small intestine , 1963, Gut.

[24]  H. A. McDonald.  Intrajejunal drip in gastric surgery. , 1954, Lancet.

[25]  R. Zollinger,et al.  Critical evaluation of jejunostomy. , 1952, A.M.A. archives of surgery.

[26]  A. Andresen.  IMMEDIATE JEJUNAL FEEDING AFTER GASTRO-ENTEROSTOMY. , 1918, Annals of surgery.

[27]  E. Rosato,et al.  Prognostic nutritional index in gastrointestinal surgery. , 1980, American journal of surgery.

[28]  J. Fischer,et al.  Nutritional benefits of immediate postoperative jejunal feeding of an elemental diet. , 1980, American journal of surgery.

[29]  S. Heymsfield,et al.  Enteral hyperalimentation: an alternative to central venous hyperalimentation. , 1979, Annals of internal medicine.

[30]  G. Blackburn,et al.  Nutritional and metabolic assessment of the hospitalized patient. , 1977, JPEN. Journal of parenteral and enteral nutrition.

[31]  H. K. Wright,et al.  Rate of water and sodium absorption from the jejunum after abdominal surgery in man. , 1970, American journal of surgery.

[32]  G. Moss.  NITROGEN EQUILIBRIUM IN THE EARLY POSTOPERATIVE PERIOD. , 1963, Surgical forum.