POSTOPERATIVE CARDIAC SURGERY PATIENTS ON ENTERAL NUTRITION SUPPORT DURING THEIR STAY IN THE INTENSIVE CARE UNIT IN THE YEAR 2017.

Uvod Osnovni je princip enteralne prehrane - ako je crijevo u funkciji, koristite ga. I male količine hrane u crijevnom lumenu mogu spriječiti atrofiju crijevnih resica, time permeabilnost crijevne zaštitne barijere, sprečavajući bakterijsku translokaciju i endotoksemiju koja može biti pokretač multisustavnog zatajenja organa. Sve su to razlozi da se enteralna prehrana primijeni i kod kardiokirurških bolesnika, koji su hemodinamski stabilni, s funkcionirajućim gastrointestinalnim traktom. Preporučuje se primijeniti enteralne pripravke unutar 48h po operacijskom zahvatu. Cilj Cilj ovog istraživanja je bio ispitati postoji li razlika između opstipiranih i neopstipiranih kardiokirurških bolesnika po tome koliko su često sedirani. Ispitati postoji li razlika između kardiokirurških bolesnika s ranom i kasnom enteralnom prehranom, po tome koliko često imaju dijareju. Potom istražiti, postoji li razlika između bolesnika hranjenih Fresubin energy drink-pripravkom i Nepro HP-pripravkom, po tome koliko često bolesnici imaju dijareju. Ispitanici i metode Istraživanje je retrospektivna, kohortna studija kojim su se analizirali podaci kardiokirurških bolesnika u kojih je bila primijenjena enteralna prehrana (EP), a koji su liječeni u Jedinici intenzivnog liječenja Klinike za anesteziologiju i intenzivno liječenje Kliničkog bolničkog centra u razdoblju 1. siječnja 2017. do 31. prosinca 2017. U istraživanje je uključeno 24 kardiokirurških bolesnika; 6 žena 18 i muškaraca, u rasponu dobi od 21 do 89 godina. Uključujući kriterij je bio dijagnoza kardiovaskularne bolesti kojima je indicirano operacijsko liječenje. U svih bolesnika uključenih u istraživanje koristila se elektronska baza podataka integriranog bolničkog informatičkog sustava (IBIS). Statistička analiza provedena je pomoću osobnog računala u programskom paketu Microsoft Excel Data Analysis. Rezultati Rezultati istraživanja su pokazali da sedirani kardiokirurški bolesnici nemaju češće opstipaciju nego nesedirani kardiokirurški bolesnici. Kardiokirurški bolesnici s ranom enteralnom prehranom nemaju učestalije dijareju nego bolesnici s kasnom enteralnom prehranom, a bolesnici hranjeni Fresubin energy drinkom rjeđe imaju dijareju nego bolesnici koji su hranjeni s Nepro HP pripravkom. Zaključak Ovim istraživanjem je utvrđeno da sedirani kardiokirurški bolesnici nemaju češće opstipaciju nego nesedirani kardiokirurški bolesnici. Kardiokirurški bolesnici s ranom enteralnom prehranom nemaju učestalije dijareju nego oni s kasnom enteralnom prehranom. Kardiokirurški bolesnici hranjeni Fresubin energy drinkom rjeđe imaju dijareju od bolesnika koji su hranjeni Nepro HP pripravkom.Introduction The basic principle of enteral nutrition - if the gut is in use, use it. The small amounts of nutrients and water in the intestinal lumen can prevent intestinal mucosal atrophy, whereby the permeability of the intestinal barrier. This prevents bacterial translocation and endotoxemia, which may be the initiator of multisectoral organ failure. All of these underlying reasons for enteral feeding include cardiac surgery patient, hemodynamically stable with a functioning gastrointestinal tract. It is advisable to start enteral nutrition administration within 48h after surgical procedure. Objective The aim of the study is to determine the effect of sedation on constipation in postoperative cardiac surgical patients in the intensive care unit. This is also examined in the study the risk of diarrhea as a result of providing early enteral nutrition compared to late enteral nutrition in a postoperative cardiac surgical patient. The objective of this study is to compare the different enteral nutrition formulas - Fresubin energy drink and Nepro HP, which may reduce diarrhea in the postoperative cardiac surgical patient. Patients and methods A retrospective cohort study was conducted on 24 (18 men and 6 women) postoperative cardiac surgical patients initiated on enteral nutrition support during their stay in the Intensive Care Unit /University Hospital Rijeka/, from January 1st to December 31st, 2017. Inclusion criteria for participation in the study were cardiovascular patients requiring cardiac surgery cardiovascular disease. The electronic database of the integrated hospital information system (IBIS) was used in all the patients involved in the study. Results The results of the study show that sedated cardiac surgical patients do not have more constipation than untreated cardiac surgical patients. Cardiac surgical patients with early enteral nutrition do not have more frequent diarrhea than those with late enteral nutrition. Cardiac surgical patients with Fresubin energy drink enteral nutrition have rarely diarrhea than those with enteral nutrition on the Nepro HP. Conclusions Based on the results obtained, this study found that sedated cardiac surgical patients have no more constipation than untreated cardiac surgical patients. Patients with early enteral nutrition do not have more frequent diarrhea than those with late enteral nutrition. Cardiac surgical patients with Fresubin energy drink enteral nutrition are less likely to have diarrhea than patients who are fed with Nepro HP, but in hyperosmolar preparations, it is possible that diarrhea is a side effect. Due to the small sample, and the time constraints, the statistical views do not have the desired strength