Adequate nutrition reportedly can help reduce the degree of muscle loss and improve muscle quality in hospitalized patients recovering from trauma. This study investigated the association between nutritional intake and changes in muscle quality and quantity in these patients. The handgrip strength (HGS) and body composition of 52 patients admitted to the trauma ward were measured at 1-week intervals. According to their dietary intake, they were categorized into the hypocaloric nutrition group (HNG; < 70% of recommended caloric intake) and the isocaloric nutrition group (ING; ≥ 70% of recommended caloric intake). Within one week, body mass index (24.3 ± 4.4 kg/m2 vs. 23.4 ± 4.5 kg/m2), body fat percentage (24.1% ± 9.8% vs. 17.2% ± 9.2%), and skeletal muscle mass (28.6 ± 4.9 kg vs. 27.5 ± 4.3 kg) significantly decreased in the ING compared with those in the HNG. Although the skeletal muscle mass decreased, the ING’s left HGS significantly increased (26.6 ± 9.6 kg vs. 28.5 ± 10.1 kg). The ING also consumed a significantly greater amount of protein (beyond the recommended amount) than the HNG (72.6 ± 43.2 → 100.8 ± 27.0% vs. 58.6 ± 25.9 → 49.5 ± 20.1%; p = 0.039). In bioelectrical impedance vector analysis, the vectors of the ING shifted more within the normal range of the 75% tolerance ellipse than those of the HNG (23% vs. 10%). These results suggest that, although the muscle mass quantitatively decreased during trauma recovery, adequate nutritional support helps preserve muscle quality.
Neurocritically ill patients often encounter challenges in maintaining adequate enteral nutrition (EN) owing to metabolic disturbances associated with increased intracranial pressure, trauma, seizures, and targeted temperature management. This case report highlights the critical role of the nutrition support team (NST) in overcoming these barriers and optimizing EN delivery in a patient with traumatic brain injury (TBI). A 59-year-old man was admitted to the neuro-intensive care unit following TBI. EN was initiated early in accordance with clinical guidelines. By the time of transfer to the general ward, 82.4% of the estimated energy requirement and 102.8% of the protein requirement were met. Despite this, the patient experienced 19.4% weight loss, likely due to underestimation of hypermetabolic demands and delays in EN advancement caused by fluctuating clinical conditions. NST adjusted the nutrition strategy by incorporating high-protein formulas, parenteral nutrition supplementation, and gastrointestinal management. This case report demonstrates the importance of individualized, multidisciplinary nutritional interventions in improving clinical outcomes for neurocritically ill patients.
Estimating the nutritional requirements for pediatric patients requires a comprehensive approach with various factors including age, gender, body mass index, and physical activity level, due to the significant growth and developmental changes observed in this population. This complexity renders the use of a simplistic generalization or a standard formula impractical. A number of methodologies have been established to calculate nutritional needs for the pediatric population. However, the application of these methodologies is challenging due to the variability in the aforementioned factors. Determining nutritional requirements for pediatric patients with underlying medical conditions is complicate, influenced by variables such as the nature of the illness, treatment modalities, and the patient’s overall condition. Nutritional support in severely traumatically brain-injured pediatric patients is directly correlated with prognosis and growth outcomes. Therefore, this case study aims to validate existing methodologies for estimating nutritional requirements in pediatric patients with severe traumatic brain injury and to provide primary data for the development of effective nutritional support strategies. A case of a 5-year-old male patient admitted to the intensive care unit due to severe traumatic brain injury is examined. Future case studies and ongoing research are imperative to ensure the safe and effective nutritional support of pediatric patients with severe traumatic brain injury.
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