Zhang Xia, Zhang Jun, You Zhi-Bo, Zhang Guo-Fang, Chen Ya, Zhou Xue-Jiao, Si Yuan-Hua, Luo Zhong, Xu Zu-Cai, Yao Ben-Hai, Cao Piao
Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Department of Neurosurgery, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
Sci Rep. 2025 Aug 22;15(1):30916. doi: 10.1038/s41598-025-12650-y.
This study investigates the effects of adding whey protein powder and Bifidobacterium quadruplex live bacterial tablets to enteral nutrition on nutritional indicators, complications, and prognosis in neurological ICU patients. Between April 2022 and December 2023, 100 patients requiring enteral nutrition in our hospital's Neurology ICU were randomly assigned to four groups (25 each): EN1 (enteral nutrition only), EN2 (enteral nutrition + Bifidobacterium), EN3 (enteral nutrition + Bifidobacterium + whey protein), and EN4 (enteral nutrition + whey protein). Nutritional indicators (albumin, total protein, prealbumin), complication rates (diarrhea, constipation, gastric issues), prognosis indicators (hospital stay, ventilator use, lung infections, antibiotic use), and APACHE II scores were compared. This study has been approved by the Ethics Committee of the Affiliated Hospital of Zunyi Medical University, NO: KLL-2021-112. We confirm that all experiments were performed in accordance with relevant guidelines and regulations. After 7 days, EN3 and EN4 groups showed significantly improved nutritional indicators compared to EN1, with EN3 outperforming EN2. Diarrhea and gastric mucosal bleeding were less frequent in EN2 and EN3 compared to EN1 and EN4. APACHE II scores improved significantly in EN3 and EN4 post-treatment. EN3 had the lowest pulmonary infection rate and reduced antibiotic use, but hospitalization time differences were not significant across groups. Metabolic indicators showed no significant differences between groups. Supplementing enteral nutrition with whey protein powder and Bifidobacterium quadruplex improves nutritional status, reduces gastrointestinal complications, and enhances prognosis in critically ill neurological patients. Trial registration: ChiCTR2300079322, (30/12/2023); Website where it was obtained: https://www.chictr.org.cn/bin/home.
本研究探讨在肠内营养中添加乳清蛋白粉和四联双歧杆菌活菌片对神经重症监护病房（ICU）患者营养指标、并发症及预后的影响。2022年4月至2023年12月期间，将我院神经ICU 100例需要肠内营养的患者随机分为四组（每组25例）：EN1组（仅肠内营养）、EN2组（肠内营养+双歧杆菌）、EN3组（肠内营养+双歧杆菌+乳清蛋白）和EN4组（肠内营养+乳清蛋白）。比较营养指标（白蛋白、总蛋白、前白蛋白）、并发症发生率（腹泻、便秘、胃部问题）、预后指标（住院时间、呼吸机使用情况、肺部感染、抗生素使用情况）及急性生理与慢性健康状况评分系统（APACHE II）评分。本研究已获得遵义医科大学附属医院伦理委员会批准，批准号：KLL-2021-112。我们确认所有实验均按照相关指南和规定进行。7天后，与EN1组相比，EN3组和EN4组营养指标显著改善，且EN3组优于EN2组。与EN1组和EN4组相比，EN2组和EN3组腹泻及胃黏膜出血发生率较低。治疗后，EN3组和EN4组APACHE II评分显著改善。EN3组肺部感染率最低且抗生素使用减少，但各组间住院时间差异无统计学意义。各组间代谢指标无显著差异。在肠内营养中补充乳清蛋白粉和四联双歧杆菌可改善重症神经疾病患者的营养状况，减少胃肠道并发症，并改善预后。试验注册号：ChiCTR2300079322，（2023年12月日30）；获取网址：https://www.chictr.org.cn/bin/home 。
