ISSN : 2146-3123
E-ISSN : 2146-3131

Are Hepatic Portal Venous System Components Distributed Equally in the Liver? A Multidetector Computerized Tomography Study
Mehmet İncedayı 1, Serkan Arıbal 1, Ali Kemal Sivrioğlu 1, Güner Sönmez 1, Ersin Öztürk 1, Cihad Çınar Başekim 1, Bülent Yalçın 2
1Department of Radiology, Gülhane Military Medical Academy, İstanbul, Turkey
2Department of Anatomy, Gülhane Military Medical Academy, Ankara, Turkey
DOI : 10.5152/balkanmedj.2012.050
Pages : 419-423

Abstract

Objective: Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU).

Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs.

Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622).

Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.

Keywords : MDCT, laminar flow, portal vein, splenic index
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