Role of intestinal lavage in the normalization of the functions of the gastrointestinal tract in patients with chronic critical illness

Abstract

BACKGROUND: The resolution of intestinal insufficiency syndrome remains one of the urgent problems of nutritional support for patients in chronic critical condition.
 Purpose of the study. To determine the effectiveness of intestinal lavage in restoring the basic functions of the gastrointestinal tract and microbiocenosis in patients in chronic critical condition.
 Materials and methods. A prospective, randomized, single-center study was performed. The study was performed in 56 affected men with TBI of various etiologies in a chronic critical condition. At the beginning of treatment and on the 10th day, the effectiveness of gastrointestinal lavage was evaluated in the complex intensive therapy of intestinal insufficiency syndrome.
 Results. Patients were randomized into two groups depending on the conduct of intestinal lavage. In the 1st group (27 patients), enteral tube feeding was performed according to the standard method. In the 2nd group (29 patients), intestinal lavage was additionally performed with the addition of an enterosorbent to the saline enterosorbent solution, 3 procedures with an interval of 3 days. In the 2nd group (main), there was a significant positive dynamics of carbohydrate and protein metabolism, restoration by the 10th day of the barrier function of the intestine, motility of the gastrointestinal tract, microbiocenosis compared with patients in the control (group 1).
 Conclusion. The inclusion of gastrointestinal lavage in the complex intensive therapy of SCI in patients in a chronic critical condition in a short time helps to resolve the main pathogenetic links of SCI - restoration of the barrier function of the intestine, digestive-transport, motor-evacuation processes in the gastrointestinal tract, normalization of microbiocenosis, metabolic parameters and nutritional status.