Effect of hypocaloric enteral nutrition on acute severe traumatic brain injury

Objective To evaluate the clinical efficacy of hypocaloric enteral nutrition in patients with acute severe traumatic brain injury (TBI). Methods A total of 100 patients with severe TBI [Glasgow Coma Scale (GCS) 3-8 points] were enrolled and randomly divided into hypocaloric enteral nutrition group (hypocaloric group, 41.86-62.79 kJ·kg-1·d-1) and traditional caloric enteral nutrition group (traditional caloric group, 104.65-125.58 kJ·kg-1·d-1), 50 patients per group. The enteral nutrition was given at 24-72 hours postoperatively. The changes of total serum protein (TP), serum-albumin (ALB), plasma hemoglobin (Hb), fasting blood glucose (Glu) and major gastrointestinal tract complications were observed and compared at 7 and 14 days after enteral nutrition support. Results Levels of TP, ALB and Hb were lowered in both groups at 7 and 14 days after nutritional support but showed no statistical difference (P>0.05). Glu was (6.37±1.02)mmol/L in hypocaloric calorie group, significantly lower than (7.35±1.70)mmol/L in traditional caloric group at day 7 after nutritional support (P 0.05), but abdominal distension, diarrhea and stomach retention rate in hypocaloric group were significantly lower than those in traditional caloric group (P<0.05). Conclusion Hypocaloric enteral nutrition can significantly reduce the stress hyperglycemia, abdominal distention, diarrhea, gastric retention and other gastrointestinal symptoms in patients with acute severe TBI. Key words: Craniocerebral trauma; Enteral nutrition; Complications