Nutritional support: a prophylaxis against stress bleeding after spinal cord injury

Paraplegia
J KuricC Sugawa

Abstract

The incidence of upper gastrointestinal (UGI) bleeding and the effect of nutritional support was studied retrospectively in 166 spinal cord injured patients. Sixty six patients included in group 1 were started on oral diet when 'clinically ready' which resulted in a haphazard manner for provision of nutrition. One hundred patients in group 2 were treated according to an organised nutrition protocol. The protocol initiates total parental nutrition (TPN) if the patient is not tolerating an oral diet by day 5. All group 2 patients met their total energy requirements (TER) within 48 hours after initiating caloric supplementation. The overall incidence of acute acid peptic ulceration leading to significant bleeding or perforation was 4%. Five of the 66 group 1 patients (7.5%) and 2 of the 100 group 2 patients (2%) developed acute ulcerations. While the exact mechanism remains unclear, this significant (p less than 0.05) reduction indicates that a nutritional regimen that meets a patients TER decreases the likelihood of acid peptic complications after spinal cord injury.

References

Jan 1, 1986·International Rehabilitation Medicine·K Walters, J R Silver
Sep 1, 1982·Injury·W E El MasriJ R Silver
Nov 1, 1981·Spine·R M GoreL Calenoff

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Citations

Jul 13, 2011·Neurocritical Care·Clemens M SchirmerAnish Bhardwaj
Apr 9, 2010·Journal of Neurotrauma·Ginette Thibault-HalmanSean Christie
Oct 7, 2005·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Stephen A McClave, Wei-Kuo Chang
Jun 15, 2012·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Alexandra Guillaume, David S Seres
Sep 21, 2017·Neurocritical Care·Jeffrey F BarlettaVictor Zach
Jan 17, 2002·The Annals of Pharmacotherapy·R MacLarenD N Fish

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