Enteral Nutrition Management in a Patient With Traumatic Brain Injury in the Neuro-Intensive Care Unit: A Case Report.

Abstract

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.