Current status of nutritional support and its relationship with clinical outcomes in children with severe traumatic brain injury

Objective To investigate the current status of nutritional support in the children with severe traumatic brain injury(TBI), and the influence of nutritional support on the clinical outcomes. Methods A total of 60 children with severe TBI who were admitted to the surgical intensive care unit(SICU) of our hospital from April 2016 to July 2017 were enrolled in this study. The clinical data like gender, age, height, weight, diagnosis and Glasgow coma scale were collected. The children were divided into two groups by actual energy intake: target energy achieved group and unachieved group. Nutritional support indexes including the start time and the way of nutritional support, interruption of enteral nutritional support, predicted target energy value and actual energy intake, incidence of infectious complications, duration of mechanical ventilation, length of SICU stay, length of total hospital stay, total hospital expenses and prognosis were compared between the two groups. Results Among 60 children recruited, 37 (61.6%) were caused by traffic accident, 16 (26.7%) were caused by falling, 7 (11.7%) by other causes. The average duration of SICU were (13.3±8.0) days. 22 (36.7%) children achieved the target energy, while 38(63.3%) failed, and the percentage of actual energy supply was 126% and 65%, respectively (P=0.000). The average age of the target achieved group was younger than that of the target unachieved group [(3.5±2.8)years vs.(6.2±3.9)years, P=0.006], while the duration of the mechanical ventilation was shorter[(2.7±3.9)days vs.(6.8±11.8)days, P=0.014], and the length of hospital stay was shorter[(16.8±7.7)days vs.(19.5±11.6)days , P=0.038]. The total hospital expenses of the target achieved group were lower than the unachieved group [(5.4±4.1)×104 yuan vs.(7.6±5.9)×104 yuan, P=0.024] Conclusions The actual energy intakes of most severe TBI children are less than their target energy. Sufficient energy supply can shorten the length of SICU and hospital stay, and reduce the total hospital expenses. Key words: Traumatic brain injury; Children; Nutritional support