NUTRITION THERAPY FOR ADULT PATIENTS WITH CAUSTIC INJURIES TO GASTROINTESTINAL TRACT

Objectives: To present here the experience of our Nutrition Therapy Team of the Hospital El Tunal, for the nutritional management of adult patients with caustic injuries to gastrointestinal tract. Materials and methods: This is a retrospective, descriptive study of patients with caustic injuries to gastrointestinal tract managed by our Nutrition Therapy Team between January 2000 and December 2007. We revisited the clinical history of patients with diagnosis of caustic injury. Various nutritional variables, as well as the evolution and outcome were pooled and analyzed. Results: A total of 30 patients, 17 male y 13 female with a mean age of 34.4 +/- 17.2 years old were found. The ingestion of caustics was suicidal intent in 22(73.3%) and accidental in 8 (26.7%). The global mortality was high (43.3%). Weight loss was found in 46.9% of the patients and a negative nitrogen balance in 62.5%. Sixteen patients (53.12%) were managed with mixed nutrition (enteral and/or parenteral) for a mean time of 24 +/- 22 days. We compared two groups Moderate vs Severe, according to the severity of the caustic injury to gastrointestinal tract and found that mortality, the length of hospital stay and the final albumin value were significantly different among groups. Conclusions: Caustic injuries to gastrointestinal tract are not frequent, they are found mainly in young patients with suicidal intent and are associated with high mortality, especially in severe injuries. This aggression causes important catabolic state leading to a negative nitrogen balance and weight loss. These patients require early nutritional intervention sometimes extended for months.