Jeong Heewon, Kim Jae Hyun, Choo Yoon-Hee, Kim Moinay, Lee Seungioo, Ha Eun Jin, Oh Jiwoong
Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea.
Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Neurotrauma. 2023 Jun 28;19(2):177-184. doi: 10.13004/kjnt.2023.19.e31. eCollection 2023 Jun.
Traumatic brain injury (TBI) is a global health and socio-economic problem, resulting in significant disability and mortality. Malnutrition is common in TBI patients and is associated with increased vulnerability to infection, higher morbidity and mortality rates, as well as longer stays in the intensive care unit and hospital. Following TBI, various pathophysiological mechanisms, such as hypermetabolism and hypercatabolism, affect patient outcomes. It is crucial to provide adequate nutrition therapy to prevent secondary brain damage and promote optimal recovery. This review includes a literature review and discusses the challenges encountered in clinical practice regarding nutrition in TBI patients. The focus is on determining energy requirements, timing and methods of nutrition delivery, promoting enteral tolerance, providing enteral nutrition to patients receiving vasopressors, and implementing trophic enteral nutrition. Enhancing our understanding of the current evidence regarding appropriate nutrition practices will contribute to improving overall outcomes for TBI patients.
创伤性脑损伤(TBI)是一个全球性的健康和社会经济问题,会导致严重的残疾和死亡。营养不良在TBI患者中很常见,与感染易感性增加、更高的发病率和死亡率以及在重症监护病房和医院的住院时间延长有关。TBI后,各种病理生理机制,如高代谢和高分解代谢,会影响患者的预后。提供充足的营养治疗以预防继发性脑损伤并促进最佳恢复至关重要。本综述包括文献回顾,并讨论了TBI患者营养方面在临床实践中遇到的挑战。重点在于确定能量需求、营养输送的时间和方法、促进肠道耐受性、为接受血管加压药的患者提供肠内营养以及实施营养性肠内营养。加强我们对有关适当营养实践的现有证据的理解将有助于改善TBI患者的总体预后。