Early Enteral Nutrition Parenteral Nutrition and Bacterial Translocation

In animal models, burns and trauma have been associated with the appearance of organisms in the mesenteric lymph nodes (MLNs). This process has been called bacterial translocation. Enteral feeding has been associated with reduced translocation in guinea pigs. In other animal studies, early enteral feeding reduced nitrogen loss and the level of cata-bolic hormones. However, human studies in patients who have been traumatized have not show any benefit of early (<24 h) enteral feeding. In addition, a prospective sampling of portal blood in trauma patients failed to confirm that translocation occurs in traumatized humans. A meta-analysis of early vs late enteral feeding showed no difference in outcome. In obese patients, a quasi-randomized trial showed that early feeding with a higher energy intake increased sepsis.

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