Enhanced metabolic regulation in II/R injury: Comparing multiroute and monoroute enteral nutrition.

OBJECTIVE: This study aimed to compare the effects of enteral nutrition (EN) administered via multiroute or via monoroute on metabolic regulation in intestinal ischemia-reperfusion (II/R) injury rat model. METHODS: The rats were divided into sham operation and II/R injury groups. The rats in each group were further treated with either multiroute or monoroute EN. Rats subjected to multiroute EN were administered a continuous infusion of 30 kcal/kg × day of nutrition via a gastric tube and additionally provided with 0.5 g of standard rat forage for oral intake q8h (for a total of approximately 20 kcal/kg × day) each day. Conversely, rats on the monoroute regimen underwent a continuous infusion of 50 kcal/kg × day of EN through a gastric tube. Hypercatabolism was evaluated by assessing skeletal muscle protein synthesis and atrophy, and insulin resistance. Moreover, serum gastrointestinal hormone levels, hypothalamic ghrelin, and neuropeptide pro-opiomelanocortin (POMC) were detected. RESULTS: In rats subjected to II/R injury, multiroute EN more effectively restored serum and hypothalamic ghrelin levels, decreased the expression of the POMC neuropeptide, decreased skeletal muscle atrophy, and enhanced skeletal muscle synthesis. These effects collectively contributed to a reduction in muscle wasting, an improvement in hypercatabolic status, and a mitigation of body weight loss. CONCLUSION: Compared with monoroute nutrition, multiroute EN may further improve hypercatabolic metabolism, reduce muscle wasting, and prevent weight loss in II/R injury rat. This research suggested that an optimized multiroute EN regimen is superior to the monoroute EN approach.