The Role of Dietitian in Improving Energy and Protein Intake in Traumatic Brain Injury Patients Admitted to the Neurosurgical Intensive Care Unit

• Main Authors: Fatemeh Ramezani Kapourchali, Ali Malekshahi Moghadam, Anoush Dehnadi Moghadam, Shahrokh Yousefzadeh-Chabok, Fatemeh Toorang, Mohammad Hassan Javanbakht, Sara Ramezani
• Format: Article
• Language: English
• Published: Guilan University of Medical Sciences 2019-11-01
• Series: Iranian Journal of Neurosurgery
• Subjects: dietitians; enteral tube feeding; intensive care unit; nutritional and clinical assessments; traumatic brain injury
• Online Access: http://irjns.org/article-1-173-en.html

Introduction:Early and sufficient nutritional support is vital to improve outcomes in patients with traumatic brain injury. This study aims to determine the effects of dietitian involvementin the nutritional and clinical outcomes inpatients with traumatic brain injuries admitted tothe neurosurgical ICU. Materials &Methods: Forty-eight male patients with traumatic brain injuries admitted to Poursina Hospital neurosurgical ICU were studied, retrospectively. Patients were divided to either receive dietitian intervention or without any nutritional recommendation(control). Demographic information, Glasgow Coma Scale and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, the timing of initial enteral feeding, the amount of energy and protein intakeon day 4, the duration of mechanical ventilation and ICU length of stay were recorded. Results:Patients under the dietitian recommendation had significantly lower timing of initial enteral nutrition compared to the other cases (P=0.02). The average energy or protein intake and the percentage of target energy or protein intake on day4 appeared to be significantly lower in the subjects in the control group than in those with nutritional intervention(P≤0.001). There was no statistically significant difference in the duration of mechanical ventilation and ICU length of staybetween different groups of patients. Conclusions:Instead of occasional consultations for exclusive cases, the daily attendance of dietitians during multidisciplinary rounds of ICU is required to assess the nutritional needs of patients.