[Effect of an original enteral feeding protocol on clinical outcome indicators in patients with acute cerebral damage of vascular and traumatic genesis].

ABSTRACT

The prospective randomized controlled study enrolled 58 patients diagnosed as having brain injury and hemorrhagic stroke. Enteral feeding was started within the first 24 hours after admission to an intensive care unit (ICU); a control group (n = 28) was given an isocalorie formula while a study group (n = 28) received a combination of a hypercalorie formula and a fiber-containing formula. In the study group, the intestine was stimulated with erythromycin within the first 3 days. Glasgow coma scale (GCS) and APACHE II scores, the degree of a systemic inflammatory response (SIR) and multiple organ failure (MOF), serum albumin and glucose levels, energy expenditure and balance, and nitrogen excretion and balance were estimated on day 10. Treatment results on day 30, length of ICU stay, AV duration, mortality, and use of blood preparations were compared. On study day 10, nitrogen and energy balances and the pattern of signs of SIR and MOF were significantly better and fresh frozen plasma and albumin solutions were used less in the study group than in the control one. There were differences in APACHE II and GCS scores, energy expenditure and nitrogen loss, plasma albumin and glucose concentrations, mortality, and volume of used packed red blood cells. The original enteric feeding protocol based on the use of dietary fiber-fortified hypercalorie diets in combination with the new method of gastric motility stimulation makes it possible to reduce the accumulation of deficiency of energy and plastic substrates, to alleviate the manifestations of SIR and MOF and to decrease the consumption of blood components and preparations.