The Impact of Hyperglycemia on Non- Diabetic patients with Traumatic Brain Injury

Award winning abstract submitted at the AICNU 2014 in Bangalore.

Authors

  • Ms.Rajeswari.A*
  • Ms.Uma Magheswari.J*
  • Dr.Balaji Venkatachalam**

Department of *Dietetics, **Critical Care, Apollo Speciality Hospital, Chennai

Back ground: This study aimed to analyze the relation of hyperglycemia in non-diabetic subjects with severe traumatic brain injury

The patients who had highest blood sugar levels greater than 200mg/dl had only two point  increase in GCS, which reflected neurologic outcome.

Methods: A prospective analysis in an intensive care unit, investigated 15 non-diabetic patients with severe traumatic brain injury. Out of which 80% were male and 20% were female.

Subjective global assessment (SGA) was done to assess the nutritional status on admission, anthropometric data-height and weight and BMI was also taken. According to the ideal body weight(IBW), calories and protein requirement  was calculated for all patients

The patients who got admitted within 24 hours with blood glucose levels greater than 200mg/dl had two units increase in Glasgow coma scale score were selected as samples for the study. Enteral nutrition was initiated for all patients  with standard formula enriched with EPA.

Among this group 90% met the prescribed calories and 85% met the protein requirement.

Results: On admission, 10patients had blood glucose level greater than 200mg/dl had a two unit Increase in Glasgow coma scale and other 5 patients between 160-200mg/dl .CBG was checked at designed intervals for all samples

On day 2 and 3, 6 patients’ blood glucose levels were between 140-160mg/dl and other 9 patients glucose level was 150-180mg/dl.On day 4 and 5 8 patients were observed with 110-122mg/dl and other 7 patients had blood glucose level of  150-160mg/dl

Standard formula enriched with EPA  had a considerable effect in maintaining normal blood glucose levels and reduce the risk of neurological complication which inturn reduced the length of stay in the hospital

Conclusions: Early hyperglycemia is associated with poor outcomes for non-diabetic patients with severe traumatic brain injury. For all tube fed patients, according to the calorie and protein requirement recommended sucrose free, lactose free, high fiber,EPA rich supplements improved to heal severity condition and prove to  reduce the length of stay in intensive care unit and the overall stay in the hospital.