Application Research On ICU Patients With Early Enteral Nutrition

Objective:to observe the ICU in the patients with severe gastrointestinal injury classification, different AGI grading tolerance of patients receiving early enteral nutrition, the amount of calories-protein reached such as7days.Methods:in patients with ICU admission, all in accordance with the ESICM (patients with severe intestinal dysfunction) recommendations, according to the weight of the patients, the acute injury of gastric bowel function (AGI) patients were divided into4, for AGI patients with grade1to grade3, in the ICU within24-48hours for the implementation of the early enteral nutrition, normal pressure to give enteral nutrient solution best first, and treat the patient well tolerated after3d power to instead. EN via nasogastric tube or nasal bowel loops by infusion pump, starting from the low concentration, low quantity of heat, first within3-5d gradually added to total amount, the clinical symptom were observed. For AGI4patients temporarily not give early enteral nutrition therapy, to relieve symptoms in patients, and to give enteral nutrition support treatment. As far as possible within7days of not for parenteral nutrition therapy. This study intends to last7days, the baseline period (DO) evaluation indicators:in patients with grade of AGI, body mass index, APACHE Ⅱ albumin, prealbumin, grading. D1:patient EN time to start;D1-7:AGI grading, EN infusion dose within24h, speed, patient’s tolerance (nausea, vomiting, abdominal distention, diarrhea, diarrhea, stool, diarrhea duration), whether to suspend EN, pause time; D7D8evaluation indicators:patients day intake of the normal pressure yield rate (D7actual intake percentage of the target volumes) and grade of AGI, body mass index, APACHE Ⅱ score albumin, prealbumin, and the incidence of complications. AGI level within48h,1～3in proportion for EN.Results:the patients of AGI grading, body mass index, APACHE Ⅱ score of albumin, prealbumin, and other indicators before and after contrast, by the early enteral nutrition therapy, patients with AGI albumin levels at various levels (non infection patients), prealbumin and transferrin levels were significantly increased earlier. Severe infection, hemodynamic instability, such as7days albumin levels drop in critical patients.Conclusion:after the early enteral nutrition and reasonable treatment, patients with AGI hierarchical levels, from the previous fall, relieve symptoms before. Patients with APACHE Ⅱ score, intra-abdominal pressure, compared before and after7days, all the previous decline.