? Tube feedings in hypotension leading to dead gut ?

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WOuld it be worth writing this up as a case report?
Maybe no one bothered writing it up in the past just accepting the fact that 
these people have a high chance of dying. Enough anegdotal evidence may lead 
to some study in the future.

Martin
----- Original Message ----- 
From: <KMATTOX at aol.com>
To: <trauma-list at trauma.org>
Sent: Wednesday, January 11, 2006 3:51 PM
Subject: ? Tube feedings in hypotension leading to dead gut ?


>
> In a message dated 1/11/2006 9:47:41 AM Central Standard Time,
> Nappio at aol.com writes:
>
> ,,, the  total blood loss could certainly have been over 75% of his
> circulating blood volume allowing for acute end organ ischemia in addition
> to
> any vasoconstriction caused by any pressors putting him on an 
> irreversible
> spiral for dead gut--DN
>
>
>
> We of course replaced that lost blood volume as we have done in many 
> trauma
> patients, who do not develop dead gut.   I have read the papers and 
> accept
> the explanations as one possible mechanism.   However, because  well over 
> 98% of
> trauma patients with massive blood replacement do not have such
> complications, I must wonder.     I went back to the 1980s  and 1990s 
> papers and looked at
> the many many papers suggesting early enteral  feedings for trauma 
> patients
> and the many tube jejunostomy papers.   I  did not find mention of dead 
> gut as
> a major problem, secondary to tube feedings  in hypotensive patients.
>
> k
>
> 

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