Enhanced enteral nutrition therapy for patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To observe the effect of enhanced enteral nutrition therapy with gastric motility drugs through nasogastric tube in treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)by mechanical ventilation. Methods Totally 60 patients with AECOPD were randomly divided into control group and treatment group, with 30 cases in each group. The control group was treated with conventional nutrition therapy, while the treatment group was treated with enteral nutrition therapy and gastric motility drugs. Levels of hemoglobin(Hb), prealbumin(PA), albumin(ALB), transferrin(TF), alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN), serum creatinine(Scr), fasting blood glucose(Glu)were compared between the two groups. The duration of mechanical ventilation, duration in ICU, total hospitalization time, time to achievement of nutritional target and mortality within 28 days were compared between the two groups. The complications of the two groups were observed. Results The levels of PA, ALB, TF, ALT and AST in the treatment group were significantly better than those in the control group on the 3^rd and 7^th day of treatment(P<0.05), but there were no significant differences in other indexes between the two groups(P>0.05). The duration of mechanical ventilation, duration in ICU, total hospitalization time, and time to achievement of nutritional target in the treatment group were significantly shorter than those in the control group(P<0.05), but there was no significant difference in mortality within 28 days between the two groups(P>0.05). There were 4 cases with vomiting, - 6 cases with abdominal distension, 2 cases with diarrhea and 5 cases with aspiration-associated pneumonia in the treatment group, and there were 2 cases with vomiting, 5 cases with abdominal distension, 2 cases with diarrhea and 3 cases with aspiration-associated pneumonia in the control group. There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusion Enhanced enteral nutrition therapy with gastric motility drugs through nasogastric tube can significantly improve the prognosis of patients with AECOPD, shorten duration of mechanical ventilation, duration in ICU, total hospitalization time, and time to achievement of nutritional target.