Influence Of Early Enteral Nutrition Combined With Probiotics On Gastrointestinal Dysfunction And Infections In Patients With Mechanical Ventilation In Intensive Care Unit

Objective: Through continuous monitoring of different nutritional support methods for patients with mechanical ventilation with gastrointestinal function, nutrition index, immune index and inflammation changes. Investigating the effect of probiotics combined with early enteral nutrition on gastrointestinal function and reduce the effect of the inflammatory response, discussing the possible mechanisms, finding the reasonable and effective nutritional support and providing a theoretical basis of nutrition ways to patients with mechanical ventilation.Method: 100 patients with mechanically ventilated were included. Patients were randomly divided into group EEN and group PEEN, setting up the same period group PN as the positive control. Group EEN and PEEN are all started receiving enteral nutrition, but group PEEN appended probiotics at the same time. Rate of gastro-oesophageal vomiting, abdominal distention, diarrhea, gastrointestinal bleeding recorded 1~3d,4~7d,8~14d and 1~14d. TSF and AMC were measured and recorded on day 0,3,7,14. N%, CRP, PCT, Ig A, Ig M, Ig G, LY, PA, Alb recorded on day 0,3,7,14. Recording patient infection site, time of mechanical ventilation, rate of two weeks weaning, ICU length of stay. Using SPSS17.0 statistical software for statistical analysis. t test and repeated measures analysis of variance were used for analysis, count data analyzed with Chi-square test or Fisher exact test. P<0.05 for the difference significant.Result:(1)The effects on gastrointestinal function: From first days to fourteenth days, Camparision of rate of abdominal distension and diarrhea, the group PEEN showed significantly lower than it in the group EEN(P<0.05); From first days to third days, the incidence of gastrointestinal dysfunction was no significant difference between two groups(P>0.05); From fourth days to seventh days, the PEEN group ‘s incidence of diarrhea is less than EEN group, the difference was statistically significant(P <0.05); From eighth days to fourteenth days, the PEEN g roup’s incidence of diarrhea and gastric retention lower than EEN group, the difference was statistically significant(P <0.05).(2)The effect on nutritional indicator: on day 14, the group PEEN showed the level of TSF and AMC higher than group PN and EEN(P<0.05); on day 14, the group PEEN showed level of PA, Hb and Alb higher than that in group of PN and EEN(P<0.05).(3)The effect on immune: on nutrition support day 3,7,14, Ig A,Ig G,Ig M,LY% show no differents among there groups(P>0.05).(4)The effect on infectious index: the level of WBC, CRP and PCT of group PEEN was significant lower than group PN and EEN on day 7 and 14(P<0.05); group PEEN total infection rate is lower than the group EEN and PN(P<0.05).(6)Other clinical outcomes: the mechanical ventilation time of group PEEN is shorter than group EEN and PN(P<0.05), the group PEEN two weeks withdrawal probability is higher than the group EEN and PN(P<0.05).Conclusion: Probiotics combined with enteral nutrition could improve gastrointestinal dysfuction and nutritional state of patients with mechanical ventilation, reducing inflammation, shorting the time of mechanical ventilation and improving mechanical ventilation withdraw risk, playing an active role of patient recovery.