Effects Of Early Enteral Nutrition On Blood Glucose Variability And Prognosis In Patients With Moderate And Severe Traumatic Brain Injury

Objective(s):To investigate the effect of early enteral nutrition on blood glucose variability and prognosis in patients with moderate and severe traumatic brain injuryMethods:A total of 71 patients with craniocerebral injury admitted to the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2019 were selected and classified into 46 medium and 25 severe patients according to GCS score.In the Early Enteral Nutrition(EEN)group and the Delay Enteral Nutrition(DEN)group,the medium TBI patients were randomly divided into EEN group(25 and 21)and EEN group(13 and 12),and severe TBI patients into EEN group(13 and 12).Glucose variability,albumin(ALB),APPACHE II,SOFA score,mechanical ventilation time,length of stay in ICU,and 28-day mortality were observed.Results:1.Early enteral nutrition and delayed EN blood glucose changes in patients with medium-sized TBI.The blood glucose variation of early EN was small and the fluctuation range of blood glucose was small.The APACHE ? score value decreased,the sofa score value decreased,the mechanical ventilation time EEN was shorter than the delayed EN time,and the prognosis was better.The early and delayed nutritional status on the 7th day were better than that at the time of admission,but the early stage was more significant,with statistically significant differences(P<0.05).There was no statistical difference in 28-day mortality.2.The changes of early enteral nutrition and delayed EN blood glucose in patients with severe TBI were statistically significant(P<0.05).The blood glucose variation degree of early EN was small,and the fluctuation range of blood glucose was small.There was no statistical difference in 28-day mortality.3.The blood glucose variability of EEN patients with medium TBI was less than that of EEN patients with heavy TBI at the early stage,and the blood glucose fluctuation range was smaller.APACHE score improved significantly and the prognosis was better.(APACHE II and SOFA scores of TBI patients with early EEN were improved compared with those on admission,with no statistical significance,but the improvement of TBI patients with delayed EN was statistically significant).Conclusion(s):1.Early enteral nutrition and delayed enteral nutrition had less effect on blood glucose variation in patients with mild and medium TBI than those with severe TBI,and had less effect on prognosis;2.Early enteral nutrition and delayed enteral nutrition had significant effects on blood glucose variability in patients with severe TBI and had a good prognosis.