[Early enteral nutrition and gastric intramucosal pH monitoring in patients with mechanical ventilation].

OBJECTIVE: To observe the effect of early enteral nutrition and the significance of gastric intramucosal pH (pHi) monitoring in patients without gastrointestinal trauma or surgery requiring mechanical ventilation in the intensive care unit (ICU).

METHODS: Depending mainly on the vital signs and recovery of intestinal peristalsis sounds, enteral nutrition (25 cases) and parenteral nutrition (15 cases) were respectively given to the 40 patients requiring mechanical ventilation 12-72 hours (early) after operation. The value of gastric pHi was monitored continuously for the following 7 days. In addition, success rate of weaning, and mechanical ventilation duration were compared between the two groups.

RESULTS: After 7 days, the success rate of weaning in enteral nutrition group was significantly higher than that in parenteral nutrition group [76% (19/25) vs. 40% (6/15), P < 0.05]. The mechanical ventilation duration in enteral nutrition group was obviously lower than that in parenteral nutrition group [(4.30+/-0.01) days vs. (8.22+/-0.02) days, P < 0.05]. The value of gastric pHi increased in enteral nutrition group on the 7th day (7.39+/-0.03 vs. 7.28+/-0.01, P < 0.05), and the value was higher than that of the parenteral nutrition group (7.30+/-0.02, P < 0.05). In addition, the restoration of passage of flatus in enteral nutrition group was significantly earlier than that of parenteral nutrition group [(47.08+/-8.33) hours vs. (67.03+/-8.03) hours, P < 0.05).

CONCLUSION: Early enteral nutrition can improve the blood perfusion and oxygenation of gastrointestinal mucosa, and the success rate of weaning of mechanical ventilation, help reduce complications, and shorten the mechanical ventilation duration. Enteral nutrition support should be given to ICU patients with mechanical ventilation as early as possible provided that the enteral function is normal.