Implementation of a Proactive Nutrition Protocol Improves Enteral Nutrition in Mechanically Ventilated Patients Admitted to the Neuro-Intensive Care Unit.

Dear Editor, The enteral mode of nutrition delivery in the critically ill confers gastrointestinal, immunologic and survival advantages over parenteral nutrition (PN), especially when initiated early. Intensive care unit (ICU) patients with traumatic brain injury (TBI) exhibit hypercatabolism, needing higher energy requirements. The focus of TBI management is cardiorespiratory resuscitation (CPR) and neuroprotective strategies, often resulting in the neglect of nutrition as an important physiologic requirement. A retrospective study was performed to determine the effectiveness of an evidence-based proactive nutrition protocol in improving the nutrition of mechanically ventilated neurosurgical patients admitted to the neuroICU (NICU).