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Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleeding

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Resumo:"Context - Early refeeding after nonvariceal upper gastrointestinal bleeding is safe and reduces hospital stay/costs. Objective - The aim of this study was obtaining objective data on refeeding after nonvariceal upper gastrointestinal bleeding. Methods - From 1 year span records of nonvariceal upper gastrointestinal bleeding patients that underwent urgent endoscopy: clinical features; rockall score; endoscopic data, including severity of lesions and therapy; feeding related records of seven days: liquid diet prescription, first liquid intake, soft/solid diet prescription, first soft/solid intake. Results - From 133 patients (84 men) Rockall classification was possible in 126: 76 score ≥5, 50 score <5. One persistent bleeding, eight rebled, two underwent surgery, 13 died. Ulcer was the major bleeding cause, 63 patients underwent endoscopic therapy. There was 142/532 possible refeeding records, no record 37% patients. Only 16% were fed during the first day and half were only fed on third day or later. Rockall <5 patients started oral diet sooner than Rockall ≥5. Patients that underwent endoscopic therapy were refed earlier than those without endotherapy. Conclusions - Most feeding records are missing. Data reveals delayed refeeding, especially in patients with low-risk lesions who should have been fed immediately. Nonvariceal upper gastrointestinal bleeding patients must be refed earlier, according to guidelines."
Autores principais:Fonseca, Jorge
Outros Autores:Meira, Tânia; Nunes, Ana; Santos, Carla Adriana
Assunto:Gastrointestinal hemorrhage Nutrition Ulcer Gastrointestinal endoscopy
Ano:2014
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Egas Moniz - Cooperativa de Ensino Superior, CRL
Idioma:inglês
Origem:Egas Moniz - Cooperativa de Ensino Superior, CRL

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