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Nutritional support for head-injured patients
T Yanagawa1, F Bunn, I Roberts
1Department of Pediatrics, Wakayama Medical College, 27, 7-bancho, Wakayama, Japan. tyanagaw@mail.wakayama-med.ac.jp
The Cochrane Database of Systematic Reviews
|July 26, 2002
Summary
Early nutritional support following head injury shows a trend toward improved survival and reduced disability. Further research is needed to confirm these benefits of early nutrition and feeding routes.
Area of Science:
- Neuroscience
- Critical Care Medicine
- Nutritional Science
Background:
- Head injury elevates metabolic demands, increasing nutritional requirements.
- Adequate nutrient provision is linked to better patient outcomes after head trauma.
- Optimal timing and route of nutritional support require further investigation.
Purpose of the Study:
- To evaluate the impact of different nutritional support strategies on mortality and morbidity in patients with head injuries.
- To compare early versus delayed nutritional support.
- To compare parenteral nutrition versus enteral nutrition.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searches of multiple databases including MEDLINE and EMBASE.
- Data extraction on mortality, disability, and infection rates.
Main Results:
- Early nutritional support demonstrated a trend towards reduced mortality (RR 0.67) and death or disability (RR 0.75).
- Enteral nutrition showed a trend towards reduced mortality (RR 0.66) compared to parenteral nutrition.
- Limited data exist for comparing jejunal versus gastric enteral feeding routes.
Conclusions:
- Early nutritional support may be associated with improved survival and functional outcomes in head injury patients.
- Further high-quality trials are necessary to confirm these findings.
- Future research should focus on both nutritional outcomes and clinical endpoints like death and disability.