An Interventional Trial using Nasojejunal Tube for Early Enteral Feeding in Critically Ill Patients with Upper Gastro Intestinal Perforation Surgeries

Background: Nutritional support is very important during inflammatory and metabolic phase assisting in the improvement of the patient outcome after surgery. Any patient who is anticipated to have no or inadequate intake should be considered for nutritional support. Nutrition support plays important role in wound healing and post operative recovery of critically ill patients undergoing emergency gastro intestinal surgery. Hence the dictum ?when the gut is working use it?. Enteral nutrition through naso jejunal tube is safe, convenient, cost-effective and route of access is very easy. In this study, we determine the benefits, safety and short-term effectiveness of early enteral feeding using naso jejunal tube in patients with upper GI perforations. Methods: Patients undergoing operative procedure for upper GI perforation in Department of General Surgery wards of Government Kilpauk Medical College Hospital, Chennai, matching the inclusion and exclusion criteria were included in this study.50 patients were included in the study and divided into 2 groups: A Group-Early enteral feeding, B Group-Nil by mouth. The randomization of the two groups will be done based on double blinded technique. Observations are tabulated according to the pre designed proforma. Results: This interventional trial compared the outcome of enteral fed group and nil by mouth group. The results were analysed and compared with other studies in literature. The appearance of bowel sounds, passage of flatus and passage of stools was earlier in early enteral fed group. The risk of wound infection and post surgical leak was less and the nutritional status of the patients also improved in study group, with the added benefit of short hospital stay. Conclusion: By this study it is observed that early enteral feeding is beneficial over nil by mouth patients. The practice of early enteral feeding should be adopted to lower the complication rate and reduce the morbidity of the critically ill gastro intestinal perforation patients.