The Role of Dietitian in Improving Energy and Protein Intake in Traumatic Brain Injury Patients Admitted to the Neurosurgical Intensive Care Unit

Objective: Early and sufficient nutritional support is vital to improve outcomes in patients with traumatic brain injury. This study aims to determine the effects of dietitian involvement in the nutritional and clinical outcomes in patients with traumatic brain injuries admitted to the neurosurgical ICU. Materials & Methods: Forty eight male patients with traumatic brain injuries admitted to Poursina hospital neurosurgical ICU were studied, retrospectively. Patients were divided to either receive dietitian intervention or without any nutritional recommendation (control). Demographic information, Glasgow Coma Scale and Acute Physiology and Chronic Health evaluation II (APACHE II) scores, timing of initial enteral feeding, the amount of energy and protein intake on day 4 day, the duration of mechanical ventilation and ICU length of stay were recorded. Results: Patients under the dietitian recommendation had significantly lower timing of initial enteral nutrition compared to the other cases (P = 0.02). The average energy or protein intake and the percentage of target energy or protein intake on day 4 appeared to be significantly lower in the subjects in control group than in those with nutritional intervention (P≤0.001). There was no statistically significant difference in duration of mechanical ventilation and ICU length of stay between different groups of patients. Conclusions: Instead of occasional consultations for exclusive cases, the daily attendance of dietitians during multidisciplinary rounds of ICU is required to assess the nutritional needs of patients.