Influence of early enternal nutrition on the immune function and outcome in patients with severe traumatic brain injury / 中华临床营养杂志

ABSTRACT

ObjectiveTo explore the influence of early enteral nutrition (EEN) on the immune function and outcome in patients with severe traumatic brain injury.MethodsTotally 131 patients with severe traumatic brain injury who were admitted to the Intensive Care Unit of our hospital between March 2010 and March 2011 were enrolled in this study.Among them,69 were in EEN group and 62 were in control group.On day 7,humoral immune function was measured using automatic biochemistry analyzer,and the peripheral blood lymphocyte subset proportions were measured using flow cytometry.The complications were recorded in the initial 7 days after trauma.ResultsCompared with the control group,the EEN group had significantly lower incidences of complications including glucose metabolism disorder,diarrhea/stomach intestine distend,infection,multiple organ dysfunction syndrome,and stress ulcer on day 7 ( P =0.000,0.002,0.001,0.004,and 0.002).Hospital mortality in the EEN group was also significantly lower than that in control group ( P =0.028).The serum levels of IgM and IgG in EEN group were significantly higher than in control group ( both P =0.000),whereas the serum levels of C3 and C4 in the EEN group were significantly lower ( both P =0.000).IgA showed no significant difference between these two groups (P =0.144).The serum levels of CD3 + CD4 + T lymphocytes,CD4 +/CD8 + T lymphocytes,and CD19 + lymphocytes in the EEN group were significantly higher than in control group (all P =0.000),while CD3 + CD8 + T lymphocytes showed no significant difference ( P =0.070 ),The serum level of CD16+ CD56+ T lymphocytes in the EEN group was significantly lower than that in control group (P =0.026).ConclusionPatients with severe traumatic brain injury have good tolerance of EEN,which may enhance the immune function and improve the outcome of the patients.