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 (DII®) 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.
Keywords: dietary inflammatory index, traumatic brain injury,
enteral nutrition, inflammation, formula