What is the recommended approach to nutrition in moderate-severe TBI?

What is the recommended approach to nutrition in moderate-severe TBI?

• A. Early enteral nutrition within 24-72 hours; avoid underfeeding
• B. Parenteral nutrition within 24 hours
• C. No nutrition for 3 days
• D. Oral nutrition only

Answer: (A)

Early nutrition through the gut is essential after moderate-to-severe TBI because the body enters a hypermetabolic, catabolic state and needs prompt calories and protein to support healing and immune function. Starting enteral feeding within 24 to 72 hours helps preserve gut mucosal integrity, reduces infectious complications, and lowers overall stress on the body compared with delaying nutrition or relying on other routes. Feeding via the gastrointestinal tract is preferable to parenteral nutrition unless the gut cannot be used, because it carries fewer infections and supports normal gut physiology. The goal is to avoid underfeeding, as insufficient calories and protein worsen lean body mass loss, impede recovery, and can prolong ICU stays. The other approaches are not suitable: giving parenteral nutrition so early carries higher infection risk and bypasses the gut’s immune and barrier benefits; withholding nutrition for several days promotes severe catabolism; and relying on oral intake only is not feasible in many patients with altered consciousness or feeding risks in the acute phase.

Early nutrition through the gut is essential after moderate-to-severe TBI because the body enters a hypermetabolic, catabolic state and needs prompt calories and protein to support healing and immune function. Starting enteral feeding within 24 to 72 hours helps preserve gut mucosal integrity, reduces infectious complications, and lowers overall stress on the body compared with delaying nutrition or relying on other routes. Feeding via the gastrointestinal tract is preferable to parenteral nutrition unless the gut cannot be used, because it carries fewer infections and supports normal gut physiology. The goal is to avoid underfeeding, as insufficient calories and protein worsen lean body mass loss, impede recovery, and can prolong ICU stays.

The other approaches are not suitable: giving parenteral nutrition so early carries higher infection risk and bypasses the gut’s immune and barrier benefits; withholding nutrition for several days promotes severe catabolism; and relying on oral intake only is not feasible in many patients with altered consciousness or feeding risks in the acute phase.