Journal of Parenteral and Enteral Nutrition

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Register here to gain access to SAGE's 500+ Journals Online

Click here to sign up for SAGE Journal Email Alerts today!

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Free Full Text Free
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Collier, B.
Right arrow Articles by Diaz, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Collier, B.
Right arrow Articles by Diaz, J., Jr
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 5, 410-415 (2007)
DOI: 10.1177/0148607107031005410


Original Communications

Feeding the Open Abdomen

Bryan Collier, DO{dagger}, Oscar Guillamondegui, MD{dagger}, Bryan Cotton, MD{dagger}, Rafe Donahue, PhD*, Andrew Conrad, BS{ddagger}, Kate Groh, BS{ddagger}, Jill Richman, BS{ddagger}, Todd Vogel, MD, MPH§, Richard Miller, MD{dagger} and Jose Diaz, Jr, MD{dagger}

From the * Department of Biostatistics, Section of Surgical Sciences, and {dagger} Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee; {ddagger} Vanderbilt University School of Medicine; and the § University of Washington, Harborview Medical Center

Correspondence: Bryan Collier, DO, CNSP, FACS, Trauma Patient Care Center, Vanderbilt University Medical Center, 404 Medical Arts Building, 1211 21st Avenue, Nashville, TN 37212. Electronic mail may be sent to bryan.collier{at}vanderbilt.edu.

Background: The purpose of this study was to determine if early enteral nutrition improves outcome for trauma patients with an open abdomen (OA). Methods: Retrospective review was used to identify 78 patients who required an OA for ≥4 hospital days, survived, and had available nutrition data. Demographic data and nutrition data comprising enteral nutrition initiation day and daily % target goal were collected. Patients were divided into 2 groups: early enteral feeding (EEN), initiated ≤4 days within celiotomy; and late enteral feeding (LEN; >4 days). Outcomes included infectious complications, early closure of the abdominal cavity (<8 days from original celiotomy), and fistula formation. Results: Fifty-three of 78 (68%) patients were men, with a mean age of 35 years; 74% had blunt trauma. Forty-three of 78 (55%) patients had EEN, whereas 35 of 78 (45%) had LEN. There was no difference with respect to demographics, injury severity, or infectious complication rates. Thirty-two of 43 (74%) patients with EEN had early closure of the abdominal cavity, whereas 17 of 35 (49%) patients with late feeding had early closure (p = .02). Four of 43 (9%) patients with EEN demonstrated fistula formation, whereas 9 of 35 (26%) patients with late feeding formed fistulae (p = .05). The EEN group had lower hospital charges (p = .04) by more than $50,000. Conclusions: EEN in the OA was associated with (1) earlier primary abdominal closure, (2) lower fistula rate, (3) lower hospital charges.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?