The Relationship between Serum Concentrations of Pro- and Anti-Inflammatory Cytokines and Nutritional Status in Patients with Traumatic Head Injury in the Intensive Care Unit

Abstract

Background and objective: The aim of the present study was to examine the relationship between serum levels of pro-inflammatory cytokines (IL-6, IL-1β, and TNF-α) and anti-inflammatory cytokines (IL-10) measured once at the baseline with changes in nutritional status of patients with traumatic head injury (THI) assessed at three consecutive times (24 h after admission, day 6 and day 13) during hospital stay in the intensive care unit (ICU). Materials and Methods: Sixty-four patients with THI were recruited for the current study (over 10 months). The nutritional status of the patients was determined within 24 h after admission and on days 6 and 13, using actual body weight, body composition analysis, and anthropometric measurements. The APACHE II score and SOFA score were also assessed within 24 h of admission and on days 6 and 13 of patients staying in the ICU. Circulatory serum levels of cytokines (IL-6, IL-1β, TNF-α, and IL-10) were assessed once within 24 h of admission. Results: The current study found a significant reduction in BMI, FBM, LBM, MAUAC, and APM, of THI patients with high serum levels the cytokines, over the course of time from the baseline to day 7 and to day 13 in patients staying in the ICU (p < 0.001). It was also found that patients with low levels of some studied cytokines had significant improvement in their nutritional status and clinical outcomes in term of MAUAC, APM, APACHE II score and SOFA score (p < 0.001 to p < 0.01). Conclusion: THI patients who had high serum levels of studied cytokines were more prone to develop a reduction of nutritional status in terms of BMI, FBM, LBM MAUAC and APM over the course of time from patient admission until day 13 of ICU admission.

The Neutrophil/Lymphocyte Count Ratio Predicts Mortality in Severe Traumatic Brain Injury Patients

“…Some of those biomarkers correlated with Glasgow Outcome Score at 6-month and with mortality in TBI patients [46]. Some authors have also shown that inflammatory cytokines are sensitive in the prognosis of post-TBI recovery and significantly correlated with 6-month outcome [47,49]. Noteworthy, the severity of TBI is commonly assessed by CT examinations, which cannot provide any information about the metabolic and inflammatory response after brain injury.…”

Time Course and Characteristics of the Nutritional Conditions in Acute Traumatic Cervical Spinal Cord Injury

“…To the best of our knowledge, the time course of patients' nutritional condition after SCI has not been reported previously, although some studies have reported nutritional findings for different forms of trauma 14 . For example, in a study evaluating patients hospitalized in the intensive care unit with a traumatic head injury, nutritional parameters significantly reduced from hospital admission to hospitalization days 7 and 13 14 . Our study demonstrated that nutritional status deteriorated until 1 month after injury; however, it gradually improved until 3 months after injury.…”

Evaluation of Calorie and Protein Intakes and Clinical Outcomes in Critically Ill Patients: Cross- sectional study

“…In general, the results of studies on the administration of high-protein diets in patients to the ICU are very controversial (20). Some observational studies have shown bene cial effects of high protein intake with clinical outcomes, while these bene ts have not been fully con rmed in clinical trial studies, however, few studies have found that very early protein intake is even harmful (21)(22)(23)(24)(25)(26). A retrospective showed that low protein intake (<0.8 g/kg/day) in the rst 3 days of ICU admission along with high protein intake ((>0.8 g/kg/day)) after the third day of admission was associated with a reduction in 6-month mortality, in addition, low protein intake throughout the all ICU stay was associated with worst clinical outcomes (27).…”