Análise da rotina de reintrodução alimentar nos pacientes em pós-operatório de cirurgias abdominais eletivas internados no CTI

Abstract

Although it offers clear clinical advantages, the early introduction of oral feeding after elective abdominal surgeries is not yet an absolute practice in all services, mainly due to doubts about patient tolerance and the safety of the procedure. The aim of this work was to observe the practice of introducing oral or enteral diet in patients admitted to the ICU after elective abdominal surgeries and to compare the frequency of fistulas and dehiscences, and other abdominal complications between groups with feeding introduced within the first 24 hours or after 24 hours postoperatively. A retrospective, observational study was conducted in the general ICU of HUCFF, during the period from November 2022 to June 2024, through the analysis of the service's database and review of medical records. Demographic data and information related to the surgical procedure, as well as the type and timing of diet introduction, severity scores, and laboratory tests in the first postoperative week were recorded. Seventy patients were included, with a median age of 64 years, 42.9% male. A lower incidence of fistulas and dehiscences was observed in the early reintroduction group compared to the late group (4.7% vs 22.2%, p=0.025), as well as reduced ICU and hospital stays (3 vs 6 days, p=0.034 and 11 vs 17 days, p=0.004) in univariate analysis, but this did not remain statistically significant after multivariate analysis. Early reintroduction of oral/enteral diet appears safe and beneficial, with potential benefits in reducing complications. Clear and well-defined interdisciplinary protocols can improve postoperative management and reduce complications, length of stay, and hospital costs.