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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