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Original Articles
- Nutritional Support Team Approach Decreases the In-Hospital Mortality Rate after Deceased Donor Liver Transplantation
- Sang-Oh Yun, Jong Man Kim, Sangjin Kim, Jinsoo Rhu, Hyun Jung Kim, Soo Hyun Park, Hyo Jung Park, Eunmi Gil, Wonseok Kang, Gyu-Seong Choi, Won Hyuck Chang, Jeong-Meen Seo, Jae-Won Joh
- Surg Metab Nutr 2020;11(1):7-11. Published online June 30, 2020
- DOI: https://doi.org/10.18858/smn.2020.11.1.7
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Abstract
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ePub - Purpose: This study compared the mortality rates between a period of time without employing a nutritional support team (NST) and a period of time with an NST.
Materials and Methods: Forty-six patients underwent adult deceased donor liver transplantation (DDLT) in 2016, and their medical records were prospectively collected. All the donor recipients underwent routine enteral feeding after liver transplantation. An NST cared for twenty-one patients after September 2016. The NST consisted of transplant surgeons, hepatologists, a critical care team, a rehabilitation team, dietitians, pharmacists, and nurses. We defined the patients within the time period without an NST as the control group and those patients within the time period with an NST as the case group.
Results: There were no statistically significant differences in baseline or perioperative characteristics between the two groups. The median model for the end-stage liver disease (MELD) score was 36 (range: 21∼40) for the control group and 36 (range: 23∼40) for the case group (P=0.596). The 30-day mortality rate was 24.0% (6/25) for the control group, but it was 4.8% (1/20) for the case group. The patient survival rates at 1-year and 2-year were 68.0% and 64.0% in the control group and 85.7% and 81.0% in the case group, respectively. However, there were no statistically significant differences of the 30-day mortality rate and 1∼2 year patient survival rate between the two groups.
Conclusion: The present study suggests that an NST should be required to prevent 30-day mortality and increase patient survival of adult DDLT patients with a high MELD score.
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- The Current Status of Enteral Feeding Management in General Surgical Ward
- Yun Jung Kim, Young Mee Baek, So Yun Kim, Mi Reu Moon, Kyung Hee Park, So Hee Paeck, Moon Young Seo, Sook Young Oh, Eun Ji Lee, Hyun Bin Lim, Ji Ye Hwang, In Sun Chung, Jae Kil Lee, Kyung Sik Kim, Chong Bai Kim
- J Clin Nutr 2015;7(1):23-27. Published online April 30, 2015
- DOI: https://doi.org/10.15747/jcn.2015.7.1.23
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Abstract
PDFePub
Purpose:
Development of a standardized guideline and assessment tool is necessary. Therefore, the aim is to investigate the current state of enteral feeding management and to develop a basis for a standardized guideline.
Methods:
From July 1, 2010 through June 30, 2011, this study was conducted retrospectively for 100 patients who had enteral feeding more than once only in the Intensive Care Unit, after General Surgery at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. The analysis was based on the following factors; age, diagnosis, name of the operation, period of start and the end of enteral feeding, method of injection, flushing method, residual volumes of the stomach, location and the size of the tube, medication through tubing, and complications related to enteral feeding.
Results:
The mean age of the patients was 60.5, 65 men and 35 women. There were 30 malignant tumors of the hepatobiliary system and pancreas, 8 gastric and duodenal cancer, 4 colon and rectal cancer, 11 peritonitis, hemoperitoneum, and bowel obstruction, and 47 others. The average period of performing enteral feeding was 11.7 days and the locations of enteral feeding tube were stomach 56%, jejunum 39%, duodenum 3%, and undescribed 2%. The methods of enteral feeding were as follows; continuous feeding 19%, cyclic feeding 75%, intermittent and bolus feeding 3%, respectively. Only 1% of patients were on flushing and 16% on stomach residual. The most common complication of enteral feeding was clogging of the tube (5%).
Conclusion:
Due to the lack of detailed charting related to enteral feeding, we were unable to analyze the statistics on the relevance of complication which was the primary endpoint. As a result, development of a standardized protocol on charting enteral feeding is suggested for optimal enteral nutritional support.
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