Nutritional assessment in head injured patients throughthe study of rapid turnover visceral proteins

Background & Aims: 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 bothenteral and parenteral nutrition (Group C) at random. We considered these paramenters: 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 Bonferroniʹs Mest. Results: Plasma prealbumin and Retinol binding protein (RBP) showed an increasing of basal valuesduring 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). Conclusion: Data obtained in the present study indicate that a laboratory is essential for monitoringnutritional 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.