Review Article

The Efficacy of Parenteral Nutrition and Enteral Nutrition Supports in Traumatic Brain Injury: A Systemic Review and Network Meta-Analysis

Table 1

Characteristics of included studies.

Author (year)RegionSample sizeTreatment arms (no.)Mean age (y)Sex (male), (%)GCS (admission)Timing to starting of nutritionOutcomes

Young, 1987USA51Early PN (23) vs. delayed EN (28)33.082.44–10Early PN: within 48 hours postinjury; delayed EN: till the termination of low wall suctionGOS; mortality; complication rate; nitrogen balance; caloric balance; nitrogen intake; lymphocyte counts; albumin levels
Mazaherpur, 2016Iran60Continuous EN (20) vs. intermittent EN (20) vs. combination EN + PN (20)34.676.73–8NAReceived energy and protein; nitrogen balance; anthropometric indicators (weight; IBM)
Robert, 1983USA38Early TPN (20) vs. delayed SEN (18)40NAMean: 7.5Early PN: within 48 h after admission; delayed EN: bowel sounds were present and the gastric residual volume was less than 100 ml/hourMortality; GOS; nitrogen balance; nitrogen intake; calorie intake; serum transferrin values; serum albumin; serum glucose level; body temperature; triceps skinfold; midarm muscle circumference; total lymphocyte count; any other complication
Justo Meirelles, 2011Brazil22EN (12) vs. TPN (10)3190.99–12Hemodinamically stableMortality; morbidity; length of stay in ICU; days of mechanical ventilation; calories and protein received daily; glucose, albumin, urea, creatinine, C-reactive protein (CRP), the ratio CRP/albumin; urinary urea nitrogen; nitrogen balance; N ingested-N excreted
Nataloni, 1999Italy45EN (15) vs. PN (15) vs. EN + PN (15)2868.9Mean: 5.5All patients: two days after ICU admissionSerum prealbumin, RBP, albumin, transferrin, nitrogen balance
Li, 2015CN120Early EN (60) vs. PN (60)52.753.3NAAll patients: starting 48 h after surgeryComplication rate, albumin (ALB), alanine aminotransferase (ALT), blood glucose (GLU) level, monitoring time and cost
Fan, 2016CN120EN (40) vs. PN (40) vs. early EN + PN (40)41.751.36–8All patients: within 48 h after admissionMortality, T lympholeukocyte subsets, plasma immunoglobulin, serum total protein, serum albumin, serum prealbumin and hemoglobin, complications, length of stay in the NICU, mechanical ventilator utilization rate, and its durations