Relation between osmolality of diet and gastrointestinal side effects in enteral nutrition.
Relation between osmolality of diet and gastrointestinal side effects in enteral nutrition.
复制标题
肠内营养中膳食重量摩尔渗透压浓度与胃肠道副作用的关系。
作者：
Mahmud K;Ripley D;Doscherholmen A Vitamin;Doscherholmen A Mcmahon;Ripley D Inhibitory;Heyssel Rm;Bozian Rc;Darby Wj;Bell Mc;Wm Steinberg;King Ce;Magnus Em;Bache;Aanderson Tr;Melbostad E Folate;Doscherholmen A;Chang S;Silvis Se
118例胃肠道功能正常的患者被随机分配到三种喂养方案中的一种，进行双盲研究，以确定饮食的张力和与饮食相关的胃肠道副作用之间的关系，并评估“起始”方案在减少肠内营养期间胃肠道副作用方面的疗效。患者接受渗透压为430 mmol（mosmol）/kg的高渗饮食（第1组），相同的饮食，但在前4天渗透压从145增加到430 mmol/kg（第2组），或等渗饮食（300 mmol/kg）（第3组）。所有饲料均无菌制备，并通过24小时鼻胃输注给药。第1组的平均每日氮摄入量显著高于（p <0.05）第2组和第3组，第1组的平均每日总氮平衡显著优于（p <0.05）第2组和第3组。与饮食相关的副作用发生率在所有三组中相似，但腹泻与抗生素联合治疗显著相关（p <0.001）。这些研究结果表明，未稀释的高渗饮食的结果显着更好的氮摄入量和平衡，启动方案减少营养摄入量，但不症状，腹泻是显着相关的抗生素治疗，而不是管理的未稀释的高渗聚合物饮食。
One hundred and eighteen patients with normal gastrointestinal function were randomly allocated to one of three feeding regimens in a double blind study to determine the relation between the tonicity of the diet and gastrointestinal side effects related to the diet and to evaluate the efficacy of "starter" regimens in reducing gastrointestinal side effects during enteral nutrition. Patients received a hypertonic diet with an osmolality of 430 mmol (mosmol)/kg (group 1), the same diet but with the osmolality increasing from 145 to 430 mmol/kg over the first four days (group 2), or an isotonic diet (300 mmol/kg) (group 3). All diets were prepared aseptically and administered by 24 hour nasogastric infusion. The mean daily nitrogen intake in group 1 was significantly greater (p less than 0.05) than that in both groups 2 and 3, and the mean overall daily nitrogen balance was significantly better (p less than 0.05) in group 1 than groups 2 and 3. The incidence of side effects related to the diet was similar in all three groups, but diarrhoea was significantly (p less than 0.001) associated with concurrent treatment with antibiotics. These findings show that undiluted hypertonic diet results in significantly better nitrogen intake and balance, that starter regimens reduce nutrient intake but not symptoms, and that diarrhoea is significantly related to treatment with antibiotics and not to administration of an undiluted hypertonic polymeric diet.