title: The Effect of Continuous Enteral Nutrition on Nutrition Indices, Compared to the Intermittent and Combination Enteral Nutrition in Traumatic Brain Injury Patients.
abstract: BACKGROUND
  Nutrition support is one of the most common care, which is undertaken for patients who suffered from Traumatic Brain Injury (TBI) and are admitted in intensive care units. Literature indicates some controversies regarding the appropriate method of nutrition support in these patients.
  
  
  OBJECTIVE
  This study was conducted for determining the effect of continuous enteral nutrition on nutrition indices, compared to the intermittent enteral and combination nutrition in TBI patients.
  
  
  METHODS
  In a randomized clinical trial, 60 TBI patients who were admitted to critical care units of Taleghani Hospital of Kermanshah-Iran in 2010 recruited to the study. The samples were allocated to three groups of continuous enteral nutrition, intermittent enteral nutrition and combination nutrition supports by random sampling. The tool was a researcher-made checklist. The three methods of nutrition support were performed to the participants, then nutrition indices of patients were measured before and during three weeks. Data were analysed using SPSS software, descriptive, and inferential statistics.
  
  
  RESULTS
  The mean of received energy in the combination group (53.1± 18.3%) was higher than continuous (38.5±19.7%) and intermittent (32.2±14.7%) groups, significantly (p<0.001). The received protein was also greater in combination method (67.7±16.9%) than continuous (31.8±15.1%) and intermittent groups (17.2±10.1%), (p=0.001). The mean of nitrogen balance was improved in continuous method from -4.7± -1.6 to 7.2±5.2, (p<0.001) significantly.
  
  
  CONCLUSIONS
  In this study, received energy of patients was not enough by three methods. However, the continuous method, having a positive effect on nitrogen balance, reducing hypercatabolism and maintaining the total body protein, was preferred to brain injury patients compared with intermittent enteral and parenteral methods that demand more studies.
authors.affiliation: MSc of Critical Care Nursing, Nursing Department, Faculty of Nursing & Midwifery, Kermanshah University of Medical Sciences , Kermanshah, Iran .
authors.forename: Sakine
authors.initials: S
authors.lastname: Mazaherpur
authors.affiliation: Associate Professor in Nursing Education, Nursing Department, Faculty of Nursing & Midwifery, Kermanshah University of Medical Sciences , Kermanshah, Iran .
authors.forename: Alireza
authors.initials: A
authors.lastname: Khatony
authors.affiliation: PhD of Nursing, Nursing Department, Faculty of Nursing & Midwifery, Kermanshah University of Medical Sciences , Kermanshah, Iran .
authors.forename: Alireza
authors.initials: A
authors.lastname: Abdi
authors.affiliation: Assistant Professor in Nutrition Science, Nutrition Department, Public Health College, Kermanshah University of Medical Sciences , Kermanshah, Iran .
authors.forename: Yahia
authors.initials: Y
authors.lastname: Pasdar
authors.affiliation: Professor in Epidemiology, Statistics and Epidemiology Department, Research and Technology center, Kermanshah University of Medical Sciences , Kermanshah, Iran .
authors.forename: Farid
authors.initials: F
authors.lastname: Najafi
keywords: Intensive care units; Mortality; Nutritional support