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ROLE OF EARLY ENTERAL NUTRITION BY NASOJEJUNAL TUBE FEEDING IN CASES OF PEPTIC PERFORATION PERITONITIS

Umesh Jethwani, Sanjay Jain, M. C. Songra

Abstract


Background: Withholding enteral feeds after an elective gastrointestinal surgery is based on the hypothesis that this period of “nil by mouth” provides rest to the gut and promotes healing.
Aims: To assess whether early postoperative naso-jejunal tube feeding in the form of a balanced diet formula is safe and beneficial in patients of peptic perforation peritonitis.
Setting: A surgical unit of a Medical College Hospital.
Design and Subjects: Prospective randomised open control study.
Materials and Methods: Patients undergoing surgical intervention for peptic perforation peritonitis were randomised to the study group receiving feedings of a balanced diet formula through a nasojejunal tube from the second postoperative day, or the control group in which patients were managed with the conventional regimen of intravenous fluid administration. The groups were compared for incidence and duration of complications, biochemical measurements and other characteristics like weight loss/gain. Statistical Analysis includes techniques like Chi square test and ‘T’ test.
Results: Eighty patients were enrolled in each group. 88% subjects in the study group achieved positive nitrogen balance on the eighth postoperative day as compared to none in the conventionally managed group. Average loss of weight between the first and tenth day was 3.10 kg in the study group as compared to 4.5 kg in the conventionally managed group (‘P’ value <0.001). Total number of complications were more in control than study group.
Conclusion: Early enteral nutrition is safe and is associated with beneficial effects such as lower weight loss and early achievement of positive nitrogen balance as compared to the conventional regimen of feeding in operated cases of peptic perforation peritonitis.

Keywords


Nasojejunal tube, Enteral nutrition, Peptic perforation peritonitis, Eternal nutrition, Nasojejunal tube feeding, Peritonitis

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References


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