Enteral Feeding in the Post-Injury Open Abdomen

Study Overview
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Brief Summary
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The purpose of this study is to determine if Enteral Feeding (EN) in patients with a traumatic bowel injury requiring an open abdomen impacts outcomes. Patients who receive EN will be compared to those who remain nil-per-os (NPO). Additionally, an internal study control will be performed by analyzing concurrent injured patients requiring an open abdomen who did not have a bowel injury. Specific aims: Hypothesis 1: EN in patients with a traumatic bowel injury requiring an open abdomen improves fascial closure rate compared to patients who remain NPO. Hypothesis 2: EN in patients with a traumatic bowel injury requiring an open abdomen reduces infectious complications compared to patients who remain NPO. Hypothesis 3: EN in patients with a traumatic bowel injury requiring an open abdomen have a lower mortality rate compared to patients who remain NPO.

Detailed Description
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Fascial closure is determine by the primary physician and should be recorded in the operative record. This record will be accessed to determine if this variable is accomplished. Additionally, any dehiscence complication will be recorded (which would impact the long-term fascial closure rate). Infectious complications (abscess, pneumonia, etc) will be adjudicated by the primary clinician and any record of this in the patient chart will be recorded.

Official Title
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Enteral Nutrition in the Open Abdomen

Conditions
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Trauma to the Abdomen

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients with a post-injury open abdomen Exclusion Criteria: Patients to be excluded from analysis include deaths within 24 hours, identification of injury > 24 hours, and those transferred from an outside hospital > 24 hours following initial injury.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 98 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| bowel injury, NPO<br>Patients with bowel injury who remain nil-per-os (fed nothing) | |
| bowel injury, EN<br>Patients with bowel injury who are fed by enteral nutrition (EN) | |
| no bowel injury, NPO<br>Patients without bowl injury who remain nil-per-os (fed nothing) | |
| no bowel injury, EN<br>Patient without bowl injury who are fed by enteral nutrition (EN) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fascial closure rate | physical exam will document fascial closure | participants will be followed for their hospital stay, which is on average expected to be 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mortality | subject mortality status | participants will be followed for their hospital stay, which is on average expected to be 1 month |