HN-01570096_Hypocaloric versus Full Caloric Enteral Feeding in Neurosurgical Patients at the Intensive Care Unit Patients; a Randomized Controlled Trial

Introduction: There are controversies regarding the optimal amount of calories for the reduction of morbidity and mortality in neurosurgical patients at the ICU. The aim of this study to compare clinical outcomes in hypocaloric vs. full caloric enteral feeding during the first week of hospitalization in neurosurgical patients at the intensive care unit.Methods: This randomized clinical trial was conducted on 560 patients who were admitted to trauma, stroke, and neurosurgery ICUs, at the end 68 patients were randomly divided into two groups, that the full caloric group, enteral feeding started at 75% of their daily energy expenditure and the hypocaloric group with 30% of caloric goal, and reached 75% of the target calories within seven days of the intervention. Both groups received 75%-100% of the daily energy requirement in the second week of hospitalization.Results: The incidence of severe gastrointestinal intolerance was relatively high in the full caloric group (P<0.001). Duration of mechanical ventilation and length of hospital stay were lower in the hypocaloric group compared to the full caloric group (P=0.014 and P=0.046, respectively). No significant differences were denoted in the length of ICU admission (P=0.163), 28-day mortality (P=0.640), and pneumonia (P=0.162) between the study groups.Conclusion: In the neurocritical care unit, hypocaloric enteral feeding may be being associated with faster recovery process, with shorter duration of ventilator dependence and length of hospital stay.