Reflux and stool frequency in the artificial feeding of traumatized intensive care patients

The effect of intragastric nutrion and its complications, especially the reflux pattern, were studied in 104 patients, who had to be intensively treated for more than 10 days. Patients suffering from polytrauma without abdominal injury (group I) or with abdominal injury (group III) and patients with isolated head/brain injury (group II) were included in this study. Parenteral nutrition was changed to intragastric administration as soon as possible and enteral nutrition was softly increased from 327 calories per day during the first week to 1800 calories or more in the next weeks. The general duration of feeding by nasogastric tube was between 16,1 and 19,8 days. The occurrence of reflux varied from 23,2% in patients of group II to 29,4% in patients of group I. Significant changes of reflux pattern were seen during the different weeks of treatment. The amount of reflux fluid was between 184,8 ml in group II and 355,4 ml in group III. The percentage of reflux fluid, if compared with the total enteral fluid administration revealed the maximum (16,6%) in patients of group III. Patients in group I had the highest frequency of defecation, the highest incidence of diarrhea was in all the groups really the same. Diarrhoea was seen in 6,7% of all patients. The underlying mechanism for these complications were discussed.