NUTRITON SUPPORT FOR TRAUMATIC BRAIN INJURY

Аннотация

Objective: to evaluate the impact of nutritional and metabolic support based on the study of the development of hypermetabolism-hypercatabolism syndrome in patients with closed traumatic brain injury. Methods: The results of the examination and complex treatment of 92 patients with CTBI of various etiologies, who were treated in the neurosurgical intensive care unit of the Republican Center for Emergency Medical Care in Tashkent from 2016 to 2020, became the materials for analysis and discussion. Various options for parenteral and enteral nutrition were studied, and the effectiveness of the use in addition to the standard nutritional support of pharmaconutrients. Results: The work carried out made it possible to establish that the metabolic response to injury already on the first day is manifested by an increase in energy needs, an increase in negative nitrogen balance, hypoproteinemia, hypotransferinemia, dyslipidemia; additional enteral administration of glutamine to patients with CTBI leads to the restoration of the functions of the gastrointestinal tract 2–3 days earlier compared to the control group of patients; The proposed complex program for the treatment of patients with CTBI with additional enteral use of pharmaconutrients and a hypercaloric enteral mixture containing dietary fiber contributed to a more rapid relief of the hypermetabolism-hypercatabolism syndrome, elimination of energy deficiency, restoration of protein metabolism, restoration of the functions of the gastrointestinal tract with a general improvement in treatment results and a decrease in mortality by 5.3 ± 0.7%. Conclusions. Our results confirm the clinical efficacy of NP, supplemented by enteral administration of pharmaconutrients in the early post-traumatic period, with a further transition to a hypercaloric mixture containing pharmaconutrients and dietary fiber, improves the results of treatment of patients with CTBI, and reduces the length of stay in the ICU.