A Role of the Nutritional Support Team in Abdominal Emergency Care

Abstract

Since the start of our nutritional support team activity in April 2002, we have treated 498 cases for a total of 2550 times. As for cases of abdominal emergency, we have treated 38 cases for a total 339 times. The patients comprised 6 cases of gastrointestinal perforation, 5 of suture insufficiency, 2 of abdominal traumatic injury, 4 of rupture of aortic aneurysm. 5 of short bowel syndrome, 4 of serious acute pancreatitis, 2 of hemorrhagic enterocolitis, one of ischemic enterocolitis, 5 of pseudomembranous colitis and 5 of acute hepatitis. Total parenteral nutrition was first employed for cases with shock or sepsis. We made it rule to control blood sugar lower than 150mg/dL with reinforcement insulin therapy. We adopted early enteral nutrition for cases whose intestinal tract was usable. We administered GFO, a functional diet which comprising of glutamine and dietary fiber and oligosaccharide. For patients with renal failure undergoing haemodialysis, we administered a 10% greater quantity of amino acids with conventional composition. We used antiinflammatory nutrients with increased n3 type fatty acids and antioxidants and reduced arginine in a case of respiratory failure and a severe infectious disease. Detection of occult blood and protein using urinalysis tape and searching for Clostridium difficile toxin in watery diarrhea were useful in the diagnosis of enterocolitis. Most patients recovered and could leave the hospital.