|
|
|
|
김영지 ( Kim Young-Ji ) - 서울대학교병원 외과계 중환자실
박옥향 ( ) - 서울대학교병원 외과계 중환자실
김은정 ( Kim Eun-Jung ) - 서울대학교병원 외과계 중환자실
김윤주 ( Kim Yun-Joo ) - 서울대학교병원 외과계 중환자실
노희정 ( ) - 서울대학교병원 외과계 중환자실
김향희 ( ) - 서울대학교병원 외과계 중환자실
오수진 ( Oh Su-Jin ) - 서울대학교병원 외과계 중환자실
임상희 ( Lim Sang-Hee ) - 서울대학교병원 외과계 중환자실
윤은숙 ( ) - 서울대학교병원 외과계 중환자실
|
|
Abstract
|
|
|
|
|
Diarrhea is a major problem in enteral feeding. As many as 68% of ICU patients experience serious diarrhea (Cataldi, Betcher E. S., 1983). Patients with diarrhea may loosing weight, they’re risk for malnutrition, dehydration, fluid-electrolyte imbalance and skin- breakdown (Anastasi, 1996). The reason that ICU patients have a severe diarrhea is typically taken medication, malnutrition, dietary change and sudden onset of disease (Thomson D. G., 1983). For the purpose of reducing diarrhea, Fiber was added to diet. Fiber does not result in malnutrition and is a low-cost method (Hart, 1988). The effect of soluble fiber can reduce diarrhea, delay gastric emptying time, increase absorption of bile salts and prolong food’s transit through the intestines (Anastasi, 1996). Although we have many reports of the effect of fiber, results of research were not same. So, we need to further research of fibers, amount, feeding method and subjects. The purpose of this study was to determine the effect of High Fiber Diet in critically ill patients with head-injured patients. Twenty patients experienced neuro-surgical operation for brain tumor and aneurism in surgical intensive care unit of SNUH(The hospital of Seoul National University) participated in this study. Control diet was the normal soft fluid diet and experimental diet was the high fiber diet. This was arranged with considerable help from the hospital dietician. Experimental diet was based on the normal soft fluid diet added soluble fiber 15g/l000Kcal. Ten experimental group subjects received a high fiber soft fluid diet. Ten control group subjects received the soft fluid diet. Both diets cost same. Both groups had a NPO about 7 or 8 days after neuro- surgical operation and then feeding was started by doctor’s order. For one month, we recorded medications induced diarrhea or constipation, weight change, GCS (glascow coma scale), pretest albumin level, demographic findings, calorie intake and oral intake of all subjects. Outcome measures to evaluate the effect of high fiber diet included frequency of diarrhea, diarrhea score of each week. Data were analyzed with mean, standard deviation, Mann-Whitney test and MacNemar test, using SPSS/WIN 8.0 program.
Results were obtained as follows
1) The frequencies of diarrhea of the experimental group in first and second week were significantly lower than those of control group (first week : Z=-2.97, p.O03, second week : z=-2.55, p=.011, third week : z-.73, p.466) 2) The diarrhea score of the experimental group in first week was significantly lower than those of control group (first weekZ-2.498, p.Ol2, second week: z-1.023, p.3O6, third week: z-.078, p.938) The results suggest that appropriate high fiber diet in critically head-injured patients can reduce the incidence of diarrhea and decrease the diarrhea severity. Applying high fiber diet in acute stage was seemed to be more effective than longterm stage.
|
|
|
KeyWords
|
|
|
|
|
원문 및 링크아웃 정보
|
|
|
|
|
등재저널 정보
|
|
|
|
|
|
|