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2 - The effects of nutritional support in congestive heart failure patients who had needed for prolonged intensive care after cardiovascular surgery
Buket Özyaprak, Ayşe Baysal, Ömer Savluk, Hüseyin Toman, İsmail Özkaynak, Tolga Totoz
Introduction and Goal: The effects of enteral alone versus combined enteral and parenteral nutritional support on biochemical parameters, morbidity and mortality were investigated in need for prolonged intensive care after cardiovascular surgery in patients with chronic heart failure.
Material and Methods: Patients were randomly divided into two groups (n=30) depending on enteral nutrition (Group 1, n=30), Group 2; combined enteral and parenteral nutrition (Group 2, n=30). On day 1, 7 and 14; glucose, cholesterol, triglyceride, albumin, alanin aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH); alkalane phospatase (ALP), total bilirubin, gamma glutamil transferase (GGT) and electrolytes were evaluated. Side effects and mortality were recorded.
Results: Demographics and all biochemical parameters revelaed no difference between groups (p>0.05). Within group comparisons revealed no change in glucose levels in Group 1 whereas, there was increase in Group 2 (p=0.01). Cholesterol and triglyceride levels in Group 1 and 2 showed a rise whereas, albumin levels decreased (p<0.001). A decrease in ALP and AST in Group 1 and a decrease in ALP in Group 2 was observed (p<0.05), there was no difference in LDH and total bilirubin levels. In Group 1, a rise in sodium and chloride levels, a decrease in calcium levels, in Group 2, a rise in sodium and potassium levels were seen. Side effects and mortality showed no difference (p>0.05).
Conclusion: Early enteral nutritional support should be considered first in postoperative period. If the required energy amount can not be achieved, enteral and parenteral nutrition can be used together.
Keywords: Nutrition, cardiac surgery, intensive care
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