Effects of probiotics combined with early enteral nutrition on endothelin-1 and C-reactive protein levels and prognosis in patients with severe traumatic brain injury

Guohua, Wan; Wang, Linlin; Zhang, Guanhong; Zhang, Jian; Lu, Yanli; Li, Jun; Yi, Xiaolan

doi:10.1177/0300060519888112

Cited by 26 publications

(23 citation statements)

References 25 publications

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“…In a study involving 67 patients, the effects of probiotics combined with early enteral nutrition on the levels of endothelin-1 (ET-1), C-reactive protein (CRP), and inflammatory factors in patients with severe traumatic brain injury (TBI) were investigated, suggesting that probiotics combined with early enteral nutrition could reduce serum ET-1, CRP, IL-6, IL-10, and TNF-α levels in patients with severe TBI, thereby increasing the recovery rate of patients. 23 Horn et al believed that 24 patients receiving high-protein formula enteral nutrition (more than 20% of calories) had a 25% higher recovery rate than those receiving normal protein content, suggesting that clinicians should strongly consider using a formula containing at least 20% of protein when possible, rather than the standard formula.…”

Section: Discussionmentioning

confidence: 99%

Clinical observation of individualized nutritional formula on inflammation index, immune status and gastrointestinal tolerance in patients with severe head injury

Zhu

Zhang²,

Li³

et al. 2021

Pak J Med Sci

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Objectives: To evaluate the clinical significance of individualized nutritional formulas on inflammatory factors, immune status and gastrointestinal tolerance in patients with severe head injury. Methods: A total of 80 patients with severe head injury who were hospitalized in Baoding No.1 Central Hospital from March 2017 to March 2020 were randomly divided into two groups with 40 cases in each group. Patients in both groups were given enteral nutrition (EN), the control group was given conventional enteral nutrition formula through nasointestinal tube, and the experimental group was given individualized nutrition formula. All patients were tested for tumor necrosis factor (TNF-α), C-reactive protein(CRP), interleukin 6(IL-6), IgA, IgM, IgG, serum intestinal fatty acid binding protein (I-FABP) and D-lactic acid concentration before and after enteral nutrition treatment. The incidence of adverse reactions such as abdominal distension, diarrhea, constipation, and gastric retention within seven days after treatment of two groups were compared and analyzed. Results: There was no significant difference in inflammatory factors such as TNF-a, CRP, IL-6, immunoglobulin levels, I-FABP and D-lactic acid concentration between the two groups before treatment (p>0.05). After treatment, the above indicators of the two groups of patients were better than before treatment, the difference was statistically significant (p<0.05), and the experimental group was significantly better than the control group (p<0.05). The experimental group had a gastrointestinal adverse reaction rate of 10%, and the control group had 27.5%, the difference was statistically significant (p=0.04). Conclusions: Individualized nutritional formula has more significant advantages than conventional nutritional formula for patients with severe head injury, which can reduce inflammatory response, increase the patient’s immune level, improve the intestinal mucosal barrier function, have good gastrointestinal tolerance, and have a low incidence of adverse reactions. doi: https://doi.org/10.12669/pjms.37.4.3987 How to cite this:Zhu C, Zhang Y, Li W, Li Q. Clinical observation of individualized nutritional formula on inflammation index, immune status and gastrointestinal tolerance in patients with severe head injury. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3987 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Clinical observation of individualized nutritional formula on inflammation index, immune status and gastrointestinal tolerance in patients with severe head injury

Zhu

Zhang²,

Li³

et al. 2021

Pak J Med Sci

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“…No significant differences were found in achievement of target energy delivery or inflammatory outcomes between groups, though those receiving EN with probiotics were found to require less insulin and have lower rates of diarrhea. In another study conducted among patients with severe TBI receiving EN, with and without probiotic supplementation, serum inflammatory markers (IL-6, Il-10, TNFalpha, and CRP) were reported to decrease more significantly among patients receiving a probiotic containing Bifidobacterium, Lactobacillus, and Enterococcus faecalis [91].…”

Section: Critical Care Interventions Impacting the Microbiomementioning

confidence: 96%

Nutrition in the Neurocritical Care Unit: a New Frontier

Tavarez

Roehl

Koffman

2021

Curr Treat Options Neurol

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Purpose of Review This review presents the most current recommendations for providing nutrition to the neurocritical care population. This includes updates on initiation of feeding, immunonutrition, and metabolic substrates including ketogenic diet, cerebral microdialysis (CMD) monitoring, and the microbiome. Recent Findings Little evidence exists to support differences in feeding practices among the neurocritical care population. New areas of interest with limited data include use of immunonutrition, pre/probiotics for microbiome manipulation, ketogenic diet, and use of CMD catheters for substrate utilization monitoring. Summary Acute neurologic injury incites a cascade of adrenergic and neuroendocrine events resulting in a pro-inflammatory and hypercatabolic state, which is associated with an increase in morbidity and mortality. Nutritional support provides substrates to mitigate the damaging effects of hypermetabolism. Despite this practice, studies on feeding delivery outcomes remain inconsistent. Guidelines suggest use of early enteral nutrition using standard polymeric formulas. Population heterogeneity, variability in interventions, complexities of the metabolic and inflammatory responses, and paucity of nutrition research in patients requiring neurocritical care have led to controversies in the field. It is imperative that more pragmatic and reproducible research be conducted to better understand underlying pathophysiology and develop interventions that may improve outcomes.

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“…A total of four articles (7,13,14,16) reported the related outcomes of nutritional support on the mortality of patients with TBI. The results of the heterogeneity test (I 2 =53%; P=0.09) indicated the presence of heterogeneity.…”

Section: Case Fatality Ratementioning

confidence: 99%

“…Four articles (7,13,14,16) reported the occurrence of lung infections in patients with TBI after nutritional support intervention. The analysis indicated I 2 =0%, P=0.99, and the comprehensive analysis results of the fixed effects model showed that the lung infection rate of the nutritional support group was lower than that of the standard nutrition group, RR =0.60, 95% CI (0.45-0.81), and the difference was statistically significant (P=0.0006), as shown in Figure 5.…”

Section: Lung Infection Ratementioning

confidence: 99%

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Systematic review and meta-analysis of the effect of nutritional support on the clinical outcome of patients with traumatic brain injury

Lü¹,

Liao²,

Hou³

et al. 2021

Ann Palliat Med

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Background: It remains unclear whether nutritional support can reduce the mortality and infection rate of patients with traumatic brain injury (TBI), improve their gastrointestinal function, and shorten the length of stay in the intensive care unit (ICU). The purpose of this study is to evaluate the effect of nutritional support on the clinical outcome of TBI patients. Methods: A computer search was conducted of the PubMed, Cochrane Library, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases for randomized controlled trials investigating the impact of nutritional support on the clinical outcomes of patients with TBI. The search included the period from the establishment of the database to July 2021. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. RevMan 5.3 statistical software (Cochrane Collaboration) was used to analyze the effect size, and a funnel plot was used to detect publication bias.Results: Seven articles reporting on 260 patients receiving nutritional support therapy compared with 252 standard nutrition control patients were included in the study. Meta-analysis showed that there was no significant difference in mortality between the nutritional support and standard nutrition treatments (RR =0.74; 95% CI: 0.34-1.60; P=0.44). However, there were significant differences in total serum protein levels

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Effects of probiotics combined with early enteral nutrition on endothelin-1 and C-reactive protein levels and prognosis in patients with severe traumatic brain injury

Cited by 26 publications

References 25 publications

Clinical observation of individualized nutritional formula on inflammation index, immune status and gastrointestinal tolerance in patients with severe head injury

Clinical observation of individualized nutritional formula on inflammation index, immune status and gastrointestinal tolerance in patients with severe head injury

Nutrition in the Neurocritical Care Unit: a New Frontier

Systematic review and meta-analysis of the effect of nutritional support on the clinical outcome of patients with traumatic brain injury

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