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Early enteral nutrition after brain injury by percutaneous endoscopic gastrojejunostomy.
JPEN J Parenter Enteral Nutr. 1991 May-Jun; 15(3):298-302.JJ

Abstract

Twenty-seven patients in a series of 52 patients with severe brain injury (Glasgow Coma Scale score less than or equal to 8) underwent insertion of intestinal feeding tubes at the bedside. The technique required endoscopy with externalization of gastric and intestinal ports through the abdominal wall. Feedings were begun through the intestinal tube with Vital HN within 4 hours of its insertion with simultaneous gastric decompression via the gastric tube. Tubes were placed 2.3 (range 0-5) days after injury. Full caloric intake (3020 kcal/24 h) was achieved by 6.8 (range 2-8) days after injury to 4.2 (range 2-8) days after placement of the feeding tube. Only 1 patient failed to tolerate feedings immediately after tube insertion. Technical inability to insert the tubes occurred in 3 patients and the intestinal tube migrated into the stomach in 2 patients; diarrhea occurred in only 1 patient. With this technique, it was possible to deliver an average daily intake of 1.2 g/kg of protein in 8-day balance periods beginning at the time of tube insertion. These data included 3- to 4-day periods in which feedings were steadily increased. In 16 patients in whom nitrogen balance was measured for 8-day balance periods, average nitrogen balance was -5.7 (range -11.3 to +3.5) g/24 h. The reduction in nitrogen loss by this technique appears equal to or superior to either gastric feeding or TPN. This technique provides the ability to enterally feed a high proportion of brain-injured patients (except those in barbiturate coma) very early after injury using a bedside procedure.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Nutrition Support Service, Virginia Commonwealth University, Medical College of Virginia Hospitals, Richmond.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

1907678

Citation

Kirby, D F., et al. "Early Enteral Nutrition After Brain Injury By Percutaneous Endoscopic Gastrojejunostomy." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 15, no. 3, 1991, pp. 298-302.
Kirby DF, Clifton GL, Turner H, et al. Early enteral nutrition after brain injury by percutaneous endoscopic gastrojejunostomy. JPEN J Parenter Enteral Nutr. 1991;15(3):298-302.
Kirby, D. F., Clifton, G. L., Turner, H., Marion, D. W., Barrett, J., & Gruemer, H. D. (1991). Early enteral nutrition after brain injury by percutaneous endoscopic gastrojejunostomy. JPEN. Journal of Parenteral and Enteral Nutrition, 15(3), 298-302.
Kirby DF, et al. Early Enteral Nutrition After Brain Injury By Percutaneous Endoscopic Gastrojejunostomy. JPEN J Parenter Enteral Nutr. 1991 May-Jun;15(3):298-302. PubMed PMID: 1907678.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early enteral nutrition after brain injury by percutaneous endoscopic gastrojejunostomy. AU - Kirby,D F, AU - Clifton,G L, AU - Turner,H, AU - Marion,D W, AU - Barrett,J, AU - Gruemer,H D, PY - 1991/5/1/pubmed PY - 1991/5/1/medline PY - 1991/5/1/entrez SP - 298 EP - 302 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 15 IS - 3 N2 - Twenty-seven patients in a series of 52 patients with severe brain injury (Glasgow Coma Scale score less than or equal to 8) underwent insertion of intestinal feeding tubes at the bedside. The technique required endoscopy with externalization of gastric and intestinal ports through the abdominal wall. Feedings were begun through the intestinal tube with Vital HN within 4 hours of its insertion with simultaneous gastric decompression via the gastric tube. Tubes were placed 2.3 (range 0-5) days after injury. Full caloric intake (3020 kcal/24 h) was achieved by 6.8 (range 2-8) days after injury to 4.2 (range 2-8) days after placement of the feeding tube. Only 1 patient failed to tolerate feedings immediately after tube insertion. Technical inability to insert the tubes occurred in 3 patients and the intestinal tube migrated into the stomach in 2 patients; diarrhea occurred in only 1 patient. With this technique, it was possible to deliver an average daily intake of 1.2 g/kg of protein in 8-day balance periods beginning at the time of tube insertion. These data included 3- to 4-day periods in which feedings were steadily increased. In 16 patients in whom nitrogen balance was measured for 8-day balance periods, average nitrogen balance was -5.7 (range -11.3 to +3.5) g/24 h. The reduction in nitrogen loss by this technique appears equal to or superior to either gastric feeding or TPN. This technique provides the ability to enterally feed a high proportion of brain-injured patients (except those in barbiturate coma) very early after injury using a bedside procedure.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0148-6071 UR - https://www.unboundmedicine.com/medline/citation/1907678/Early_enteral_nutrition_after_brain_injury_by_percutaneous_endoscopic_gastrojejunostomy_ L2 - https://doi.org/10.1177/0148607191015003298 DB - PRIME DP - Unbound Medicine ER -