Analysis of therapeutic effect of enteral nutrition through naso-intestinal tube combined with naso-gastric tube in patients with severe traumatic brain injury

Objective To investigate the therapeutic effect of enteral nutrition through naso-gastric tube combined with naso-intestinal tube in patients with severe traumatic brain injury (sTBI). Methods A total of 104 eligible sTBI patients admitted to Neurosurgery Department of Shanxi Provincial People′s Hospital from January 2011 to December 2015 were enrolled into this retrospective study. According to the ways of enteral nutrition, all 104 patients were divided into naso-gastric tube nutrition group (n=50) and naso-gastric combined with naso-intestinal tube nutrition group (n=54) in order to evaluate their differences in rate of complications related to enteral nutrition (esophageal reflux and aspiration, abdominal distension and diarrhea, upper gastrointestinal bleeding, pulmonary infection and blood sugar disorders), the time duration required for achieving target amount of enteral nutrition, mean hospitalization time and body temperature and mechanical ventilation time at ICU (intensive care unit) between the 2 groups. Results The 2 groups were comparable in the patient’s sex, age, causes of trauma, trauma types, Glasgow coma score, surgical treatment and starting time of enteral nutrition (all P>0.05). The rates of esophageal reflux and aspiration (5.6%, 3/54), parenteral nutrition (7.4%, 4/54), blood sugar disorders (9.3%, 5/54) in naso-gastric combined naso-intestinal tube group were significantly lower than those in nasogastric tube group [22.0% (11/50), 28.0% (14/50), 26.0% (13/50), respectively, all P 0.05). Compared with the patients in the naso-gastric tube nutrition group, the time to nutrition target (84.5±19.0 h vs. 42.0±8.0 h), average mechanical ventilation time (77.2±24.5 h vs. 34.3±21.8 h) and mean treatment time (18.2±4.4 d vs. 14.1±3.8 d) at ICU were significantly shorter in naso-gastric tube combined naso-intestinal tube group. However, there was no significant difference in the mean temperature at ICU between the 2 groups. Conclusions The enteral nutrition treatment with naso-gastric combined naso-intestinal tube for sTBI could significantly reduce the rates of esophageal reflux and aspiration, parenteral nutrition and blood sugar disorders and shorten the time required to reach the nutrition target, average mechanical ventilation time and mean treatment time at ICU. It is meaningful to improve the enteral nutrition treatment process for sTBI patients. Key words: Craniocerebral trauma; Enteral nutrition; Complications; Naso-intestinal tube; Naso-gastric tube; Nutritional therapy