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-469900292100Kingdom of Saudi Arabia. Ministry of education Paper

Words: 776, Paragraphs: 25, Pages: 3

Paper type: Essay , Subject: Education

-469900292100Kingdom of Saudi Arabia

Ministry of education

Taibah university

Collage of applied medical science

Clinical nutrition department

00Kingdom of Saudi Arabia

Ministry of education

Taibah university

Collage of applied medical science

Clinical nutrition department

center23002457459410012100center818008745855Name: Amal Mohammed Al-zahrani

ID:3751352 , Date: 4/April/2019941009200Name: Amal Mohammed Al-zahrani

ID:3751352 , Date: 4/April/2019

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4572005238750The title: study about the Effect of ecological immune-enhancedenteral nutrition on patients withgastrointestinal fistulas00The title: study about the Effect of ecological immune-enhancedenteral nutrition on patients withgastrointestinal fistulascenter2813050Research report assignment

00Research report assignment

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The study is about patients with gastrointestinal (GI) fistula ,ecological immune-enhanced eternal nutrition and its effect on GI fistula, GI fistula is abnormal opening in the digestive tract usually caused by operations, injury, inflammation or infection and it causes the fluids to leak out of gastrointestinal tract (GIT) (?umskien?, ?veikauskait?, Kondrackien?, & Kup?inskas, 2016), it may cause inflammation and other complications, the output is different from patient to another (100ml-1000ml) depending on the patients status and the causes of the fistula and the comprehensive therapy, also it is associated with increase needs of energy and fluids requirements due to loss in nutrients, electrolytes, vitamins and minerals, the Objective of The study aims at finding out the effects of early ecological immune enhanced enteral nutrition on the immune function, nutritional status and intestinal mucosal barrier in patients with GI fistulas. Medical management of a GI fistula should include maintaining the fluid and electrolyte balance, providing bowel rest and nutritional support, initiating treatment with medication, ensuring skin protection, and containing the fistula effluent (Nagata et al., 2009), immunonutrition may improve the status of critically ill and surgical patients and by improving the immune function it may reduce the complications of the disease. Some diseases may develop GI fistula like: inflammatory bowel diseases, steroid application and trauma. Ecological immune-enhanced enteral nutrition (EIEN) treatment is adding probiotic bacteria to enhance the effects of nutritional support, suppress the overgrowth of pathogenic bacteria of the gut and protect the intestinal microecology and function of the intestinal mucosal barrier and to enhance the the nutritional status and immune function recovery (Kudsk, 2006) (Shao & Xu, 2013).

Hypothesis: determine the effects of early ecological immune-enhanced enteral nutrition (EIEN) on the nutritional status, immune function and intestinal mucosal barrier in patients with gastrointestinal fistulas.

Method: The study used randomized control method by choosing 58 patients with GI fistula,26 women and 28 men from age 23-69 years old and divide them into two groups (ecological immune-enhanced nutrition [EIEN] group is 28 patients) and (parental nutrition [PN] group 26 patients), multiple radiography examinations were performed to determine the fistula’s location, the method exclude patients with endocrine or metabolic disorders, immune insufficiency, cardiac, hepatic, renal or respiratory dysfunction, a history of radiotherapy or treatment with immunosuppressive drugs and a terminal state, also BMI is not included in this study because the nutritional index is observed by the serum albumin (ALB), prealbumin (PA) and transferrin levels. In the EIEN group doscopy distal was inserted to the fistula and a nutritional catheter to administer EIEN that contain protein nutrition powder and polymeric diet like glutamine granules and bifidobiogen, the intake of the calories was scheduled, and the intake of the formula is increased over the days until it reaches the target rate (20-25kcal/kg each day, tolerance of the formula is recorded everyday , the symptoms and sign were nausea, diarrhea and other symptoms. In PN group, they received normal infusion, their formula contains amino acids, minerals, vitamins, glucose and fat emulsion, the distribution was 40-50% fat and 5—60%glucose, each group received antibiotics and the same treatment and nursing, monitor of CD3, CD4 and CD4/CD8 ratios for the 2 weeks and if there was any difference.

Results: the formula was tolerated in all patients (54), there was no difference between the EIEN group and the PN group regarding severity, complications and biochemical data, but the EIEN group recovered faster than the PN group, comparing the immune function, the nutrition index and the index of the intestinal mucosal barrier before the nutritional support (D-1) and at post-nutritional support day 7 (D7) and day 14 (D14), there were significant differences between the 2 groups and CD3, CD4 and CD4/CD8 ratios gradually returned to normal levels and were higher in the EIEN group than the PN group.


The EIEN is safe and can improve the function of immune system and nutritional status of patients with GI fistula better than PN according to the results, the goal is to maintain electrolytes balance, bowel rest and to prevent dehydration, the EIEN is quite hard and challenging for the health care providers, it needs practice and skills.References:

(?umskien?, ?veikauskait?, Kondrackien?, & Kup?inskas, 2016)

(Kudsk, 2006)

(Shao & Xu, 2013)

(Nagata et al., 2009)

About the author

This sample is completed by Emma with Health Care as a major. She is a student at Emory University, Atlanta. All the content of this paper is her own research and point of view on -469900292100Kingdom of Saudi Arabia. Ministry of education and can be used only as an alternative perspective.

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