Effects of sequential nutritional support on nutritional status and expression of regulatory T lymphocyte in patients with early severe traumatic brain injury

Kai Jia,1 Xin Tong,1 Fang Liang2 1Department of Nutrition, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; 2Department of Hyperbaric Oxygen, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China Objective: To investigate the effects of sequential nutritional support on nutritional status and immune regulation in patients with early severe traumatic brain injury (STBI). Patients and methods: A total of 62 patients diagnosed with STBI enrolled from Chaoyang Hospital (Beijing, China) from February 2015 to October 2016 were divided into two groups. The observational group (n=34) was given sequential nutritional support and the control group (n=28) was given the standard formula of whole protein enteral preparations. The energy supply for the two groups was 30 kcal/kg/d and protein 1.6 g/kg/d, respectively. The albumin (ALB), total protein (TP), high-sensitivity C-reactive protein (Hs-CRP), neuron-specific enolase (NSE), Glasgow Coma Score (GCS), and regulatory T cells before and after nutritional treatment were measured in both groups. Results: At the 14th day, the levels of ALB (41.7±4.2 g/L) and TP (70.6±4.9 g/L) were significantly higher than those in the control group (33.5±2.3 g/L and 62.3±3.9 g/L) (P<0.05). The levels of Hs-CRP and NSE were significantly lower in the observational group (0.96±0.82 mg/L and 11.96±7.82 ng/L) than in the control group (1.17±0.74 mg/L and 19.17±6.74 ng/L) (P<0.05). The GCS score in the observational group (11.5±2.9) was significantly higher than that in the control group (8.1±1.7) (P<0.05). The percentage of Tregs in the peripheral CD4+ lymphocytes was significantly lower in the observational group than in the control group (P<0.05). Conclusion: The effect of sequential nutritional support is better than conventional nutritional support in patients with STBI. The findings call for early identification of malnutrition and individual nutritional support. Keywords: severe traumatic brain injury, enteral nutrition, sequential nutrition, regulatory T lymphocyte