| ORIGINAL ARTICLE |
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| Year : 2013 | Volume
: 5
| Issue : 9 | Page : 523-528 |
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A comparative analysis of nasogastric and intravenous fluid resuscitation in patients with malignant obstructive jaundice prior to endoscopic biliary drainage
Kavita Baghel1, Saloni Raj1, Induja Awasthi1, Vishal Gupta1, Abhijit Chandra1, Rajeshwar Nath Srivastava2
1 Department of Surgical Gastroenterology, King George's Medical University, Lucknow, India
2 Physical Medicine and Rehabilitation Center, King George's Medical University, Lucknow, India
Correspondence Address:
Rajeshwar Nath Srivastava
Department of Physical Medicine and Rehabilitation Center, King George's Medical University, Lucknow - 226 003, Uttar Pradesh
India
 Source of Support: Council of Science and Technology, UP, Govt. of Uttar Pradesh, Lucknow, India., Conflict of Interest: None  | Check |
DOI: 10.4103/1947-2714.118932
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Background: An alternative to intravenous is nasogastric fluid administration through normal functioning gut. Though not common, this practice has significance in mass causalities and elective situations. Aim: The study was designed to compare nasogastric and intravenous fluid resuscitation in malignant obstructive jaundice (OJ) and their effect on endotoxemia. Materials and Methods: Sixty patients with malignant OJ undergoing endoscopic biliary drainage were randomized into two groups. A total of 4 l of fluid (Ringer's lactate) was administered to Group A through nasogastric tube and to Group B through intravenous route for 48 h. Vital parameters, serum bilirubin, serum creatinine, creatinine clearance rate, electrolytes, and endotoxemia were monitored. Results: Significant improvement in blood pressure (Group A, P = 0.014; Group B, P = 0.020) and significant decrease in serum bilirubin level (Group A, P = 0.001; Group B, P < 0.0001) was observed in both groups after resuscitation. Significantly decreased (P = 0.036) post hydration endotoxin level was observed in Group A as compared to Group B. Febrile events were significantly higher (P = 0.023) in Group B as compared to Group A (6 vs 0). Electrolyte abnormalities were found more in Group B, however statistically insignificant. Conclusion: In OJ patient undergoing biliary drainage, preoperative fluid resuscitation through nasogastric tube may be helpful in reducing postoperative septic complications and endotoxemia. |
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