Nutritional assessment in head injured patients through the study of rapid turnover visceral proteins.
OBJECTIVE
Nutritional monitoring of rapid turnover visceral protein is important in the recognition of malnutrition in patients admitted to the Intensive Care Unit (ICU). We studied prealbumin and retinol-binding protein in patients who received three different kinds of artificial nutrition in order to evaluate the appropriateness of artificial nutrition.


METHODS
45 consecutive head injury patients received enteral (Group A), parenteral (Group B) or both enteral and parenteral nutrition (Group C) at random. We considered these parameters: prealbumin, retinol binding protein and nitrogen balance before (T1), after 3 (T2), 7 (T3) and 11 (T4) days after the beginning of study. Statistical analysis was performed with Kruskal-Wallis test and Bonferroni's t -test.


RESULTS
Plasma prealbumin and Retinol binding protein (RBP) showed an increasing of basal values during the study period in all groups (<< 0.0001) and more significantly in group A (Enteral nutrition P < 0. 001 vs Total parenteral nutrition (TPN) and Enteral P<< 0.01 vs Enteral and parenteral nutrition).


CONCLUSIONS
Data obtained in the present study indicate that a laboratory is essential for monitoring nutritional assessment and for checking the appropriateness of nutritional therapy. We found prealbumin to be the most sensitive measure and found it to be the test of choice for early assessment and intervention.
Nataloni
S
S
Medical and Surgical Emergiencies Department, Intensive Care Unit, University of Ancona, Ancona, Italy.
Gentili
P
P
Marini
B
B
Guidi
A
A
Marconi
P
P
Busco
F
F
Pelaia
P
P
D018806:APACHE; D000328:Adult; D006259:Craniocerebral Trauma / Q000145:classification / Q000378:metabolism* / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009584:Nitrogen / Q000378:metabolism; D015596:Nutrition Assessment; D010289:Parenteral Nutrition, Total; D011228:Prealbumin / Q000378:metabolism*; D012177:Retinol-Binding Proteins / Q000378:metabolism*; D054839:Retinol-Binding Proteins, Plasma
D011228:Prealbumin; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma; D009584:Nitrogen