Effects of early enteral nutrition on intestinal permeability and the development of @entity881 after XXXX .

@entity1 @entity2656 @entity1230 @entity881 @entity130
OBJECTIVE: To determine how immediate enteral nutrition (EN) affects gut permeability and the development of @entity881 ( @entity881 ) in multiply injured @entity1 . DESIGN: Prospective, randomised clinical trial. SETTING: 20-bed surgical intensive care unit (ICU), university hospital. @entity1 : 28 consecutive multiply injured @entity1 , admitted in shock and stabilised in 6 h. INTERVENTIONS: @entity1 were randomly assigned to EN started not later than 6 h after admission to the ICU (group A), and to EN started later than 24 h after admission (group B). MEASUREMENTS AND MAIN RESULTS: The lactulose/ @entity2656 (L/M) test was performed in @entity1 on days 2 and 4 after @entity130 , and in 5 healthy volunteers. @entity881 scores were calculated daily. The mean @entity881 score from day 4 onwards was 1.84 in group A versus 2.81 in group B (p < 0.002), and was correlated with the time of initiation of EN after injury and the L/M ratio on day 2. The median L/M ratio on day 2 was 0.029 for group A and 0.045 for group B, while on day 4 it was 0.020 and 0.060, respectively. On day 2 after @entity130 , the L/M ratio was significantly higher in group B (p < 0.05) than in normal volunteers (median 0.014) and was positively correlated with the time of starting EN. CONCLUSIONS: In contrast with normal volunteers, the @entity1 started on EN later than 24 h after admission to the ICU demonstrated increased intestinal permeability on the second day after sustaining @entity1230 . Also, they had a more severe form of @entity881 than the group placed on EN immediately upon admission. However, early EN had no influence on the length of ICU stay or the time of mechanical ventilation.
