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The effect of Low Dietary Inflammatory Index score formula on inflammatory, metabolic and clinical outcomes in critically ill Traumatic Brain Injury patients: A Single-blind randomized controlled pilot Study
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  • Sajedeh Jandari,
  • Reza Rezvani,
  • Sajedeh Yousefian,
  • Negin Mosalmanzadeh,
  • Mohammad Bagherniya,
  • Davood Soleimani,
  • Seyedeh Zeynab Mousavian,
  • Nitin Shivappa,
  • JAMES HEBERT,
  • Ali Jafarzadeh Esfahani,
  • Abass Akhgari,
  • Lida Jarahi,
  • Mohammad Safarian
Sajedeh Jandari
Mashhad University of Medical Sciences
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Reza Rezvani
Mashhad University of Medical Sciences
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Sajedeh Yousefian
Varastegan Institute for Medical Sciences
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Negin Mosalmanzadeh
Varastegan Institute for Medical Sciences
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Mohammad Bagherniya
Isfahan University of Medical Sciences
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Davood Soleimani
Kermanshah University of Medical Sciences
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Seyedeh Zeynab Mousavian
Kerman University of Medical Sciences
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Nitin Shivappa
University of South Carolina Arnold School of Public Health
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JAMES HEBERT
University of South Carolina Arnold School of Public Health
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Ali Jafarzadeh Esfahani
Mashhad University of Medical Sciences
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Abass Akhgari
Mashhad University of Medical Sciences
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Lida Jarahi
Mashhad University of Medical Sciences
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Mohammad Safarian
Mashhad University of Medical Sciences
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Abstract

Aim: In Traumatic brain injury (TBI) patients, a complex cascade of inflammatory responses is frequently observed following trauma. Numerous dietary agents have long been found to have potential in modulating inflammatory responses. This pilot study, designed an enteral formula with low inflammatory properties based on the dietary inflammatory index (DIIĀ®) and evaluated its effect on inflammatory and metabolic factors in critically ill TBI patients. Methods: This Single-blind randomized controlled pilot study conducted at the Neurosurgical ICU of Shahid Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were randomly assigned to receive either low-DII-score or standard formula at the Intensive Care Unit (ICU). The primary outcomes of the study included clinical status, inflammatory biomarkers, APACHE II, SAPS II, SOFA, and NUTRIC scores. Results: The trial groups did not differ significantly on baseline values. Following 14 days of intervention, there was a statistically significant decrease in the APACHE II, SAPS II, and NUTRIC scores and a significant increase in GCS score in the low-DII-score formula group compared to the standard formula group. Over two weeks, high sensitivity c-reactive protein (hs-CRP) values -2.73 (95% CI: -3.67, -1.79) mg/dL in the low-DII-score formula group vs. 0.65 (95% CI: -0.29, 1.58) mg/dL in controls. Moreover, the length of hospital stay was longer for the standard formula group than for the low-DII-score formula group. Conclusion: The low-DII-score formula improves inflammatory factors (serum hs-CRP) and metabolic biomarkers (LDL-c and FBS). Furthermore, clinical outcomes, including the length of hospital stay and disease severity appear to be enhanced.

Peer review status:UNDER REVIEW

11 May 2021Submitted to International Journal of Clinical Practice
24 May 2021Assigned to Editor
24 May 2021Submission Checks Completed
28 May 2021Reviewer(s) Assigned