Nutritional therapy in the mechanically ventilated patients with acute brain injury

Abstract

Background. Acute brain injury (ABI) is an acute cerebral disorder resulting from a trauma or cerebrovascular event (including subarachnoid hemorrhage, intracranial hemorrhage, or acute ischemic stroke). Therapeutic options for ABI are limited. The outcome of the disease is largely determined by the complications that arise during ABI. Hypoxia and infection take a special place among complications. Therefore, respiratory and nutritional therapy (NT) are important technologies that should be used in the intensive care of patients with ABI. Materials and methods. We exa­mined 63 patients with ABI. They were divided into 2 groups: the first group consisted of 23 people (retrospectively) and the second group of 40 patients (prospectively). Patients of both groups did not differ in age, sex, ABI severity, and anthropometric data. Nutritional dysfunction was diagnosed based on the albumin, transferrin, serum iron levels and the absolute lymphocyte count. In patients of both groups, NT was carried out according to the ESPEN and ASPEN guidelines, and provided them with energy (25–30 kcal/kg body weight), carbohydrates (4–5 g/kg body weight at a rate of infusion of 0.5 g/kg/h), nitrogen (1.5–2 g/kg), fats (up to 2 g/kg). In the second group, NT with an increased protein content was performed. Conclusions. NT with increased protein content contributed to a reduction in duration of mechanical ventilation and stay in the intensive care unit. The last was the result of a decrease in the incidence of infection-associated tracheobronchitis and pneumonia.

Keywords

• acute brain injury
• respiratory therapy
• nutritional therapy