ABSTRACT
The intestinal flora and the intestinal environment in which it resides together constitute the intestinal microecosystem, it is significantly disturbed in neurocritical ill patients, as manifested by the decrease of bacterial diversity, an increase of pathogen, and the destruction of the intestinal barrier. Appropriate enteral nutrition is effective in maintaining intestinal barrier stability, regulating intestinal immune function, inhibiting intestinal inflammation, and regulating specific intestinal microbiota and intestinal function. It is important for sustaining intestinal microecological balance, reducing clinical complications in patients, and is a new target for the treatment of neurocritical ill patients. This review elaborates the alteration of intestinal microecology and treatment options recommended by current clinical guidelines in neurocritical ill patients and summarizes the research progress of the effects of enteral nutrition and several nutritional additives on intestinal flora and intestinal functions, to provide a reference for the follow-up research.
ABSTRACT
A 73-year-old man was scheduled for the surgical reduction of fractured femur which occurred ar 3 months ago by the accident. The mental status of the patient was stuporous (Glasgow coma scale: 5) due to the complication of the head trauma. We performed nerve blocks (femoral, sciatic, lateral femoral cutaneous, and illiohypogastric nerve blocks) for the surgical reduction of left femur with 55 ml of 0.25% ropivacaine. The electroencephalography was monitored continuously during the 4 hour operation as well as monitoring the hemodynamic and respiratory parameters. The operation was performed successfully and the patient recovered uneventfully.