Prevention of intestinal insufficiency syndrome after cardiac surgery with cardiopulmonary bypass

Introduction. Taking timely measures to prevent intestinal failure syndrome (IFS) is important for improving clinical outcomes, especially in cardiac surgery patients undergoing cardiopulmonary bypass (CPB).
Аim. To evaluate the clinical efficacy of enteral administration of saline electrolyte solution (SES) to prevent the development of IFS in cardiac surgical patients undergoing CPB.
Materials and methods. An open-label, prospective, randomized, controlled trial was conducted in patients in the cardiac surgery department of anesthesiology and intensive care. Patients aged 18 to 90 years who had undergone cardiac surgery with CPB or venoarterial extracorporeal membrane oxygenation were included. Patients in Group 1 received SES via a nasogastric tube for 12–16 hours during the first three days, and from the second day this was combined with enteral tube feeding. Patients in Group 2 received “Regidron” solution according to the same regimen. The severity of the IFS was assessed using the GIF and AGI scales. Intra-abdominal pressure, the volume of enteral nutrition absorbed, and the duration of intestinal paresis were measured.
Results. In group 2, the APACHE-II and SOFA scale scores were statistically significantly higher on days 2 and 3 compared to group 1. On days 3 and 7, the AGI and GIF scale scores were also statistically significantly higher in group 2. Normal stool was returned in 35% of patients in group 1 on day 2 and in 58% on day 5. In group 2 – this was the case in 33% on day 3 and in 44% on day 5.
Conclusion. The SES usage for the prevention of the development of IFS in patients after cardiac surgery with CPB contributed to the stabilization of the patient’s state, a decrease in the severity of IFS manifestations, early restoration of intestinal motility, maintenance of water-electrolyte homeostasis, and the prevention of the development of some organ dysfunctions.

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