Continuous Parenteral Nutrition to Reduce Pneumonia: Its Effects on Severe Head Injury Patients in Hasan Sadikin Hospital Bandung, Indonesia
| Main Authors: | Yudoyono, Farid; Department of Neurosurgery, Faculty of Medicine, Universitas Padjajaran - Dr. Hasan Sadikin Hospital, Arifin, Muhammad Z.; Department of Neurosurgery, Faculty of Medicine, Universitas Padjajaran - Dr. Hasan Sadikin Hospital |
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| Format: | application/pdf eJournal |
| Bahasa: | eng |
| Terbitan: |
Universitas Kristen Maranatha
, 2013
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| Online Access: |
http://majour.maranatha.edu/index.php/jurnal-kedokteran/article/view/898 |
Daftar Isi:
- The aim of this study was to compare the effects of enteral-, standard- and continousparenteral nutrition therapy to reduce incidence of pneumonia in severe head injury (SHI) patients. We used nutrition therapy as one of the treatments for reducing pneumonia in SHI patients. Twenty one brain-injured patients with peak 24-hour admission Glasgow Coma Scale (GCS) scores of 4-8 were prospectively and randomly assigned to receive continuous total parenteral nutrition (TPNC) for 24 hours nonstop, total parenteral nutrition standard (TPNS) and enteral nutrition (EN) in March-May 2011. Patients were observed up to 14 days post injury. Pneumonia was assessed by using clinical, radiology and laboratory tests with the incidence of pneumonia significantly different among groups (p<0.05). The GCS changes over time among groups were significantly different; nutritional assessment parameters such as anthropometry were not significantly different among groups; total lymphocyte count was significantly increased in TPNC group; albumin was significantly increased in 7th and 14th day post injury in TPNC group (p < 0.05). Absolute lymphosit count was significantly increased on 7th day and 14th day post injury in TPNC group (p < 0.05). Incidence of pneumonia was significantly decreased in TPNC group (p < 0.05). Calories and protein given by TPNC within 24 hours nonstop can be administered better in acute SHI patients than by EN via nasogastric routes. Neurological recovery from SHI occurs more rapidly in patients with better and earlier nutritional support, especially in TPNC group.