[Nutritional care of severe acute head injury patients: formulas for early enteral alimentation]

Abstract

The objectives of this study were: 1) to determine a suitable enteral alimentation formula to meet calorie and protein requirements in acute severe head injury; and 2) to evaluate the effect of different alimentation formulas on the outcomes of 60 patients, who suffered from acutely severe head injury without other major injuries and who were treated without steroids. These patients were randomly divided into three groups and enteral feeding was started within 24 hrs. of admission or postoperative. Among the two study groups Group I was fed a high protein (2.5-3.0 g/kg), high calorie (BEE x 1.2 x 1.6) diet, and Group III was fed a moderately high protein (2.0-2.5 g/kg), high calorie diet. The control group (Group II) was fed a normal protein (1-1.5 g/kg), normal calorie (30-35 Kcal/kg) diet. There were no significant differences between the three groups in anthropometric measurements, visceral protein, total lymphocyte count, and creatinine height index. The percentage of ideal body weight change in Group III patients (-4.2 +/- 1.0%) was significantly different (p less than 0.01) from Group I (-8.1 +/- 1.0%) and Group II (-11.8 +/- 1.8%). The discharge coma scale and 6-month outcomes were not significantly different between the three groups. This study demonstrated that a moderate high protein (2.0-2.5 g/kg), high calorie (BEE x 1.2 x 1.6) diet offers better nutritional status. The outcome of severe head injury patients did not change with the different enteral nutritional support formulas.