Effects of nutritional support route on intestinal structure and function in the early stage of severe burn injury

Objective:To assesstheclinicaleffectsof enteralnutritionon intestinalstructureandfunctionintheearly stageof severeburns.Methods :Nineteencasesof severeburninjuryweredividedrandomlyintoenteralnutrition group(EN)andparenteralnutritiongroup(PN).Gastrin,motilin,malondialdehyde(MDA),superoxidedismutase(SOD),endotoxin,tumornecrosis(TNF),diamineoxidase(DAO)andlactulose/mannitol(L/M)weredeterminedon postburnday1,4,8,14(PBD)respectively.Results:Serumgastrinandmotilinon PBD4and8weresignificantly higherinENgroupthanin PN group(P<0.05-0.01).PlasmaMDAon PBD4andPBD8was obviouslylowerin EN groupthaninPNgroup(P<0.01).PlasmaSODon PBD4andPBD8was significantlyhigherinENgroupthaninPN group(P<0.01).Atthemosttimepoints,endotoxinandTNFweresignificantlylowerinENgroupthaninPN group(P<0.01).SerumDAOtendedto decreaseinENgroup,andon PBD4itwasobviouslylowerinENgroupthaninPN group(P<0.01).GutpermeabilityL/Mon PBD4,PBD8wasobviouslyinENgrouplowerthaninPN group(P<0.05-0.01).Therewas positivecorrelationbetweenL/MandDAO,andbetweenMDAandTNF(P<0.05-0.01),and negativecorrelationbetweenL/MandSOD(P<0.01).Conclusion:On thebasisof thefindings,itis consideredthat theearlyenteralnutritionis moreeffectiveto preservethesecretionandmotilityof gastrointestinaltract,decrease intestinalischemiaandreperfusioninjury,reduceintestinalpermeability,decreaseplasmaendotoxinandmediators,andmaintainmucosabarrierfunction.Enteralnutritionis superiorto parenteralnutritionintheearlystageof severe burninjury.