Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury

Li, Xiaomin; Yang, Ya-Feng; Feei, Zheng; Gao, Shan; Yuan, Ning; Zhao, Ling; He, Zhangya; Luo, Xiaoqin

doi:10.1080/1028415x.2020.1765114

Cited by 11 publications

(13 citation statements)

References 25 publications

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“…About 50% of severe TBI patients experience feeding intolerance, particularly in the first week after injury, which is correlated with injury severity (33). While the incidence of diarrhea in TBI patients in intensive care units (ICUs) ranged from 10.5% to 74% (33,35,36) and positively contributed to length of hospitalization (35), diarrhea may not be a specific result of TBI, as it has a high incidence in critically ill patients receiving enteral nutrition. Other GI-related outcomes experienced by TBI patients include gastroparesis (34,37) and impaired lower esophageal function (38), which also contribute to food intolerance.…”

Section: Tbi Pathophysiology and Long-term Consequencesmentioning

confidence: 99%

Brain-gut axis dysfunction in the pathogenesis of traumatic brain injury

Hanscom¹,

Loane²,

Shea‐Donohue³

2021

Journal of Clinical Investigation

105

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Section: Tbi Pathophysiology and Long-term Consequencesmentioning

confidence: 99%

Brain-gut axis dysfunction in the pathogenesis of traumatic brain injury

Hanscom¹,

Loane²,

Shea‐Donohue³

2021

Journal of Clinical Investigation

105

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“…Nutritional therapy is an integral part of the clinical treatment of patients with TBI and can promote postoperative recovery and reduce the occurrence of related complications (19,20). In enteral/parenteral nutrition, adding glutamine, alanyl-glutamyl, probiotics, growth hormone, and other fortified nutritional preparations has a significant protective effect on the intestinal mucosal barrier function after stress (21)(22)(23), enteral nutrition provides nutrients through a nasogastric tube, and parenteral nutrition is injected intravenously. Fortified nutritional preparations provide energy for the intestinal mucosa and not only maintain its barrier function but also prevent intestinal toxins from entering the bloodstream and causing bacterial translocation (5,8).…”

Section: Discussionmentioning

confidence: 99%

“…Intensified enteral nutrition can effectively improve the immune function of patients with TBI, thereby reducing the infection rate and promoting recovery. Cooperating with scientific and reasonable nursing plans is also an essential means of ensuring the smooth implementation of enteral nutrition (18,22,24).…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of the effect of nutritional support on the clinical outcome of patients with traumatic brain injury

Lü¹,

Liao²,

Hou³

et al. 2021

Ann Palliat Med

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Background: It remains unclear whether nutritional support can reduce the mortality and infection rate of patients with traumatic brain injury (TBI), improve their gastrointestinal function, and shorten the length of stay in the intensive care unit (ICU). The purpose of this study is to evaluate the effect of nutritional support on the clinical outcome of TBI patients. Methods: A computer search was conducted of the PubMed, Cochrane Library, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases for randomized controlled trials investigating the impact of nutritional support on the clinical outcomes of patients with TBI. The search included the period from the establishment of the database to July 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. RevMan 5.3 statistical software (Cochrane Collaboration) was used to analyze the effect size, and a funnel plot was used to detect publication bias.Results: Seven articles reporting on 260 patients receiving nutritional support therapy compared with 252 standard nutrition control patients were included in the study. Meta-analysis showed that there was no significant difference in mortality between the nutritional support and standard nutrition treatments (RR =0.74; 95% CI: 0.34-1.60; P=0.44). However, there were significant differences in total serum protein levels

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“…Enteral nutrition is considered the best nutritional approach when the gastrointestinal tract is structurally and functionally intact, since its association with the decreasing of T regulatory cells in the lamina propria of the intestinal epithelium, whit a consequent reduction of the inflammatory state [25]. Moreover, enteral nutrition resulted to contribute in maintaining nutrient metabolism in patients with neurologically critical diseases [5]. However, the use of enteral nutrition can produce some adverse risks, as refeeding syndrome, increased volume of gastric residues, diarrhoea and constipation [26].…”

Section: Discussionmentioning

confidence: 99%

“…Neurological patients have a hypermetabolic and hypercatabolic state with severe nitrogen loss and rapid deterioration of the lean body mass [5]. It can harm the patient's health and affect his rehabilitation recovery [6].…”

Section: Introductionmentioning

confidence: 99%

Is the natural feed the better nutritional therapy in patients with severe acquired brain injury? A retrospective study

Andaloro

Caliri

Corallo

et al. 2021

Clinical Nutrition Open Science

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Background: This retrospective study aimed to assess whether the use of natural foods, also in combination with enteral nutrition, improves rehabilitative recovery in patients severe acquired brain injuries. Methods: 40 severe acquired brain injuries patients (75% males, aged 50.2 ± 16.6) were selected. The study population was divided into three groups based on the type of nutrition administered (enteral, oral, and mixed). Mini Nutritional Assessment and Level of Cognitive Functioning scales were used to assess changes from admission to discharge in each group. Multiple logistic regression model was performed to assess the association between the feeding typology and nutritional recovery. Results: At admission, about 97.5% of patients were malnourished. We found significant score changes from baseline to follow-up for both test used and in each subgroup, except for the subgroup that includes patients fed with enteral nutrition. There were significant differences in biochemical indicators, including levels of albumin (p < 0.01) and protein (p < 0.001), compared to baseline and follow-up. Oral nutrition resulted to be a significant predictor for nutritional improvement. Conclusions: Nutrition therapy within a multi-disciplinary team may improve both the hospital care and the recovery in severe acquired brain injuries population. Notably, our findings suggest that natural nutrition is superior to enteral nutrition in improving

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Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury

Cited by 11 publications

References 25 publications

Brain-gut axis dysfunction in the pathogenesis of traumatic brain injury

Brain-gut axis dysfunction in the pathogenesis of traumatic brain injury

Systematic review and meta-analysis of the effect of nutritional support on the clinical outcome of patients with traumatic brain injury

Is the natural feed the better nutritional therapy in patients with severe acquired brain injury? A retrospective study

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