NUTRITION SUPPORT PRACTICES IN CRITICALLY ILL HEAD INJURED PATIENTS: A GLOBAL PERSPECTIVE

The Relationship between Serum Concentrations of Pro- and Anti-Inflammatory Cytokines and Nutritional Status in Patients with Traumatic Head Injury in the Intensive Care Unit

Background and objective: The aim of the present study was to examine the relationship between serum levels of pro-inflammatory cytokines (IL-6, IL-1β, and TNF-α) and anti-inflammatory cytokines (IL-10) measured once at the baseline with changes in nutritional status of patients with traumatic head injury (THI) assessed at three consecutive times (24 h after admission, day 6 and day 13) during hospital stay in the intensive care unit (ICU). Materials and Methods: Sixty-four patients with THI were recruited for the current study (over 10 months). The nutritional status of the patients was determined within 24 h after admission and on days 6 and 13, using actual body weight, body composition analysis, and anthropometric measurements. The APACHE II score and SOFA score were also assessed within 24 h of admission and on days 6 and 13 of patients staying in the ICU. Circulatory serum levels of cytokines (IL-6, IL-1β, TNF-α, and IL-10) were assessed once within 24 h of admission. Results: The current study found a significant reduction in BMI, FBM, LBM, MAUAC, and APM, of THI patients with high serum levels the cytokines, over the course of time from the baseline to day 7 and to day 13 in patients staying in the ICU (p < 0.001). It was also found that patients with low levels of some studied cytokines had significant improvement in their nutritional status and clinical outcomes in term of MAUAC, APM, APACHE II score and SOFA score (p < 0.001 to p < 0.01). Conclusion: THI patients who had high serum levels of studied cytokines were more prone to develop a reduction of nutritional status in terms of BMI, FBM, LBM MAUAC and APM over the course of time from patient admission until day 13 of ICU admission.