Journal of Clinical Nutrition & Dietetics

Early initiation of nutrition in trauma brain injury (TBI) - our experience of 50 patients

World Congress on Nutrition and Dietetics
June 18-19, 2018 Paris, France

Vinita Mewada and Nitin Garg

Bansal Hospital, Bhopal, India

Posters & Accepted Abstracts: J Clin Nutr Diet

DOI: 10.4172/2472-1921-C1-003

Abstract

Objective: Objective of this study is to highlight the benefits of initiating early feeding for severe head injury patients. Method: This is the analysis of 50 patients of severe head injury treated at Bansal Hospital, Bhopal from 2014 to 2017 with a minimum follow up of 6 months. All patients with glasgow coma score less then 8 are included in this analysis. GCS on admission, CT scan findings, and nutrional assessment has been done through SGA (subjective global assessment). Types of surgical intervention were recorded. Early tracheostomy was done in majority of patients to facilitate early weaning from ventilator. Resolution of edema on scan, duration of ventilation, duration of stay in ICU, secondary complication like infection was analysed. Detailed review of nutrition, calories and protein requirement were calculated initiation of percutaneous endoscopic gastrectomy (PEG), weight loss and micronutrients and immuno nutrition and caloric intake was done. Result: The pool data demonstrated that early feeding was associated with significant reduction in rate of mortality (relative risk RR=0.35; 95% CI. 0.24-0.50), poor outcomes (RR=0.70; 95%CI, 0.54-0.91) and infectious complications (RR=0.77; 95%CI, 0.59- 0.99). Compared with nasogastric feeding, PEG nutrtion showed slightly reduction in the rate of mortality (RR=0.61; 95%CI, 0.34- 1.09) poor outcome (RR=0.73, 95%CI, 0.51-1.04) and infectious complications (RR=0.89; 95%CI, 0.66-1.22). Continous immune enhancing formula was associated with a significant reduction in infection rate as compared with the standard formula (RR=0.54; 95%CI, 0.35-0.82). Continous bag feeding was found to be associated with decrease in incidence of pneumonia compared with intermittent feeding (RR=0.41; 95%CI, 0.22-0.76). Conclusion: After TBI, early inititaion of nutrition is recommended. Entral nutrition is superior and has improved outcome. Our results support the use of continues gravity bag feeding and immune enhancing formula in reducing infectious complications and weight loss.