Enteral therapy in patients with blunt abdominal trauma

A retrospective and prospective study included 24 patients (18 (75%) men and 6 (25%) women) with blunt abdominal trauma who underwent examination and treatment at the Sklifosovsky Research Institute for Emergency Care. Age of patients ranged from 38 to 81 years (mean 50.1±13.6).

RESULTS

Enteral therapy was followed by normalization of serum lactate, alanine aminotransferase and aspartate aminotransferase after 3 days. There were significant differences in decrease of lactate dehydrogenase, alanine aminotransferase and C-reactive protein. In the control group, these parameters decreased only by the 10^th day.

CONCLUSION

Inclusion of saline enteral solution into the complex therapy contributes to earlier recovery of gastrointestinal function and prevents compartment syndrome. These aspects reduced the number of patients with multiple organ failure.

Keywords:

mesenteric malperfusion

intestinal barrier

peristalsis

saline enteral solution

Authors:

Rogal M.L.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-1051-7663

Yartsev P.A.

Sklifosovsky Research Institute for Emergency Care

SPIN RSCI: 4044-9661
Scopus AuthorID: 55970485700
ResearcherID: P-9151-2017
ORCID: 0000-0003-1270-5414

Zhigalova M.S.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-4520-1124

Teterin Yu.S.

Sklifosovsky Research Institute for Emergency Care

SPIN RSCI: 8888-5490
Scopus AuthorID: 57194386231
ORCID: 0000-0003-2222-3152

Staleva K.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0009-0009-6014-2522

Kiselev V.V.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0002-0170-7775

Tsuleiskiri B.T.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0002-1687-1308

Petrikov S.S.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-1141-2919

Received:

13.03.2023

Accepted:

29.06.2023

List of references:

Aleksandrov VV, Maskin SS, Ermolaeva NK, Matyukhin VV. Conservative management of patients with closed trauma of the parenchymal organs of the abdominal cavity and retroperitoneal space, with retroperitoneal hemorrhages — indications, technique and expediency. Zhurnal im N.V. Sklifosovskogo Neotlozhnaya Meditsinskaya Pomoshch=Russian Sklifosovsky Journal of Emergency Medical Care. 2021;10(3):540-548. (In Russ.). https://doi.org/10.23934/2223-9022-2021-10-3-540-548
Baklykova NM. Composition and preparation of media for intra-intestinal administration in peritonitis. Methodological recommendations Ministry of health of the RSFSR. M. 1986. (In Russ.).
Berdnikov GA. Intestinal lavage in the complex therapy of destructive pancreatitis: Dis. ... kand. med. nauk. M. 2008. (In Russ.). https://viewer.rsl.ru/ru/rsl01003168805?page=1&rotate=0&theme=white
Dyuzheva TG, Shefer AV. Intra-abdominal hypertension in patients with severe acute pancreatitis. Pirogov Russian Journal of Surgery = Khirurgiya. Zhurnal imeni N.I. Pirogova. 2014;1:21-29. (In Russ.).
Inozemtsev EO, Grigoriev EG, Apartsin KA. The actual issues of associated injuries (from the materials of polytrauma journal). Polytrauma. 2017;1:6-11. (In Russ.).
Morozov IA, Ishkova VYu, Lysikov YuA. On the digestive function of the epithelial mucous layer of the small intestine. Sechenov physiological journal of the USSR. 1990;76(4):515-522. (In Russ.).
Pankratov AA, Khatkov IE, Izrailov RE, Kapustin VI, Mamonov DA. The possibility of conservative management of blunt and penetrating liver trauma of various severity. Almanac of Clinical Medicine. 2015;40:132-137. (In Russ.).
Matkevich VA, Kiselev VV, Syromyatnikova ED, Grishin AV, Ermolov AS, Luzhnikov EA, Musselius SG, Goldfarb YuS, Petrov SI. Way to detoxify the body. Patent N.2190412/10.10.2002. (In Russ.). https://bd.patent.su/2190000-2190999/pat/servl/servlet6b63.html
Popugaev KA, Savin IA, Goriachev AS, Oshorov AV, Polupan AA, Kalinin PL, Kutin MA, Lubnin AYu. Intraabdominal hypertension and secondary abdominal compartment-syndrome in the patient with craniopharyngioma in postoperative period. Zhurnal Voprosy Neirokhirurgii Imeni N.N. Burdenko. 2011;75(1):66-71. (In Russ.).
Samokhvalov IM, Gavrilin SV, Meshakov DP, Nedomolkin SV, Suvorov VV, Denisov AV, Markevich VYu, Suprun TYu, ZHirnova NA. Severe concomitant closed abdominal trauma: features of the course of traumatic disease (first communication). Messenger of anesthesiology and resuscitation. 2018;15(3):34-40. (In Russ.). https://doi.org/10.21292/2078-5658-2018-15-3-34-40
Seliverstov PA, Shapkin YuG. Assessment of severity and prediction of the outcome of polytrauma: the current state of the problem (review). Modern technologies in medicine. 2017;9(2):207-218. (In Russ.). https://doi.org/10.17691/stm2017.9.2.25
Sigua BV. Diagnosis and surgical tactics in traumatic liver injuries: Dis. ... d-ra med. nauk. SPb. 2015. (In Russ.). https://viewer.rsl.ru/ru/rsl01005569083?page=1&rotate=0&theme=white
Tulupov AN, Besaev GM, Sinenchenko GI. Peculiarities of providing medical care to victims with polytrauma in road traffic accidents in St. Petersburg. Ekologiya cheloveka = Human ecology. 2015;22(6):3-8. (In Russ.).
Khubutia MSh, Rogal ML, Yartsev PA, Gulyayev AA, Tlibekova MA, Chernish OA, Levitsky VD. Possibilities of videolaparoscopy in the treatment of patients with abdominal trauma. Herald of surgical gastroenterology. 2012;3:74-80. (In Russ.).
Health care In Russia. M.: Rosstat; 2019. (In Russ.). https://rosstat.gov.ru/bgd/regl/b19_34/Main.htm
Agbroko S, Osinowo A, Jeje E, Atoyebi O. Determinants of Outcome of Abdominal Trauma in an Urban Tertiary Center. Niger J Surg. 2019;25(2):167-171. https://doi.org/10.4103/njs.NJS_2_19
Fitzpatric ER. Open abdomen in trauma and critical care. Crit Care Nurse. 2017;37(5):22-45. https://doi.org/10.4037/ccn2017294
Papadimitriou-Olivgeris M, Panteli E, Koutsileou K, Boulovana M, Zotou A, Marangos M, Fligou F. Predictors of mortality of trauma patients admitted to the ICU: a retrospective observational study. Braz J Anesthesiol. 2021;71(1):23-30. https://doi.org/10.1016/j.bjane.2020.12.006