The Role of Dietitianin in Improving Energy and Protein Intake in TBI Patients Admitted to the Neurosurgical ICU

Abstract

Background and Aim: 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 involvement in the nutritional and clinical outcomes in patients with traumatic brain injuries admitted to the neurosurgical ICU. Methods and Materials/Patients: Forty-eight male patients with traumatic brain injuries admitted to neurosurgical ICU of Poursina Hospital, Rasht were studied retrospectively. Patients were divided to either receive dietitian intervention or remain 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 intake on 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 day 4 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 stay between different groups of patients. Conclusion: 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.