• Jose Acosta-Escribano, Miguel Fernández-Vivas, Teodoro Grau Carmona, Juan Caturla-Such, Miguel Garcia-Martinez, Ainhoa Menendez-Mainer, Manuel Solera-Suarez, and José Sanchez-Payá.
• Intensive Care Unit, Hospital General Universitario de Alicante, Pintor Baeza 12, 03010, Alicante, Spain. acosta_jos@telefonica.net
• Intensive Care Med. 2010 Sep 1; 36 (9): 1532-9.

PurposeTo evaluate the efficacy of transpyloric feeding (TPF) compared with gastric feeding (GF) with regard to the incidence of ventilator-associated pneumonia in severe traumatic brain injury patients (TBI).Design And SettingProspective, open-label, randomized study in an intensive care unit of a university hospital.PatientsOne hundred and four CHI adult patients admitted for TBI between April 2007 and December 2008. Patients were included within the first 24 h after ICU admission and were followed until discharge or 30 days after admission.InterventionPatients were randomized to TPF or GF groups. They received the same diet, with 25 kcal kg(-1) day(-1) of calculated energy requirements and a nitrogen intake of 0.2 g N kg(-1) day(-1). Primary outcome was the incidence of early and ventilatory-associated pneumonia. Secondary outcomes were enteral nutrition-related gastrointestinal complications (GIC), days on mechanical ventilation, length of ICU stay and hospital stay, and sequential organ failure assessment score (SOFA).ResultsThe TPF group had a lower incidence of pneumonia, OR 0.3 (95% CI 0.1-0.7, P = 0.01). There were no significant differences in other nosocomial infections. The TPF group received higher amounts of diet compared to the GF group (92 vs. 84%, P < 0.01) and had lesser incidence of increased gastric residuals, OR 0.2 (95% CI 0.04-0.6, P = 0.003).ConclusionsEnteral nutrition delivered through the transpyloric route reduces the incidence of overall and late pneumonia and improves nutritional efficacy in severe TBI patients.

33 keywords...

hide…