Effect of trophic homeostasis on time of development and nature of purulent-septic complications in patients with severe combined trauma

The article presents a study of the effect of early and balanced artificial therapeutic nutrition on the correction of water and protein metabolism, as well as the frequency of development and nature of purulent-septic complications in patients with severe combined trauma in the early post-traumatic period. The study involved 19 patients with severe concomitant injury. According to the SAPS ii scale, the probability of mortality was on average 50 % (from 45 to 60 points). in terms of energy supply, patients were divided into three groups: nutritional support less than 30 % (7 patients), 30-70 % (7 patients), more than 70 % of the calculated energy needs (5 patients). The control group i included patients who received hospital meals or who could not have early enteral nutrition due to intestinal paralysis (about 1,000 kcal per day). Group ii consisted of patients who, for various reasons, had a late onset of enteral feeding or had been incomplete. Total caloric content was up to 2,000 kcal per day. The third group consisted of patients who received artificial nutritional therapy, including intravenous infusions of glucose and amino acid solutions, as well as enteral polysubstrate mixtures. The total calories amount was 3,000 kcal per day. it is confirmed that the development of catabolic hypermetabolism is characteristic of severe traumatic illness in the acute period. Among patients who received early artificial medical nutrition in the hyperelementation mode, there was an improvement in albumin binding capacity, frequency and severity of pneumonia and multiorgan failure at 10-14 days after injury.

trophic homeostasis, nutritional support, severe concomitant injury, enteral nutrition, artificial nutrition, bacterial translocation, systemic inflammatory response, hypercatabolism

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