Nutritional support: a prophylaxis against stress bleeding after spinal
cord injury. Kuric J. Lucas CE. Ledgerwood AM. Kiraly A. Salciccioli GG. Sugawa C. Paraplegia. [JC:oqt] 27(2):140-5, 1989 Apr. The incidence of upper gastrointestinal (UGI) bleeding and the effect of nutritional support was studied retrospectively in 166 spinal cord injured patients. Sixty six patients included in group 1 were started on oral diet when 'clinically ready' which resulted in a haphazard manner for provision of nutrition. One hundred patients in group 2 were treated according to an organised nutrition protocol. The protocol initiates total parental nutrition (TPN) if the patient is not tolerating an oral diet by day 5. All group 2 patients met their total energy requirements (TER) within 48 hours after initiating caloric supplementation. The overall incidence of acute acid peptic ulceration leading to significant bleeding or perforation was 4%. Five of the 66 group 1 patients (7.5%) and 2 of the 100 group 2 patients (2%) developed acute ulcerations. While the exact mechanism remains unclear, this significant (p less than 0.05) reduction indicates that a nutritional regimen that meets a patients TER decreases the likelihood of acid peptic complications after spinal cord injury.
Original Text by Clifford R. Wheeless, III, MD.
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