INFLUENCE OF INTESTINAL FAILURE SYNDROME ON THE CLINICAL COURSE OF TRAUMATIC DISEASE IN PATIENTS WITH THORACIC AND ABDOMINAL TRAUMA
Objective - to analyze the course of traumatic disease in thoracic and abdominal injured patients with intestinal failure syndrome. Materials and methods. A prospective study of 86 patients with thoracic and abdominal injuries who underwent treatment in the ICU was conducted. 2 comparison groups were formed. The IFS group (n = 26) included patients with intestinal failure syndrome, in the program of nutritional support of which parenteral nutrition was used. The EN group (n = 60) included patients with good tolerance for early enteral nutrition. Nutritional status was assessed by blood total protein, albumin and the absolute count of lymphocytes on days 1, 3, 5, 7 in the ICU. The development of nosocomial infectious complications was recorded for the entire stay in hospital using the Federal Clinical Guidelines «Epidemiological Surveillance of Infections Associated with the Provision of Medical Care» (2014). Results. Early enteral nutrition as far as parenteral nutrition allow to administer the same amount of protein and energy. The dynamics of the main indicators of nutritional status in both groups statistically differed on the day 3. In the EN group, the count of blood lymphocytes was significantly higher. In the IFS group nosocomial infectious complications developed significantly more often (p = 0.027). The most significant changes were registered in infections of surgical area (p = 0.05) Conclusion. The development of intestinal failure syndrome significantly increases the relative risk of nosocomial infectious complications and leads to a statistically significant increase in the length of stay in ICU (p = 0.005) and in the hospital (p = 0.009).