الفهرس 
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Abstract
This study was carried out in El-Minia University Hospital in the period from October 2007 to April 2008 on 50 patients of both sex with acute traumatic brain injury (GCS > 8) admitted to ICU. Patients were randomly divided into two equal groups: group I (early enteral nutrition, n=25), feeding was initiated early within 12 hrs of ICU admission & group II (delayed enteral nutrition, n=25), feeding was initiated after 48 hrs of ICU admission. Both groups received the same nutritional formula for a minimum of 5 days.
The aim of this work is to assess the effect of early enteral nutrition on patients’ outcome after acute traumatic brain injury.
Assessment and follow up of the ICU patients included monitoring of blood pressure, pulse, oxygen saturation, arterial blood gases, temperature, radiological assessment including brain CT scan and abdominal sonar, routine laboratory investigations including CBC, liver and renal functions and electrolytes, GCS which considered the most important predictor of outcome and APACHE II Score at admission and at the 1st day, 3rd day, 5th day and at discharge. Assessment also included length of stay in ICU, length of stay at hospital, mortality rate and occurrence of complications.
We can summarize the results of this study that, group I (early enteral nutrition) is superior to group II (delayed enteral nutrition) in outcome of acute traumatic brain injured patients as showed in results of GCS changes and APACHE II score changes between the two groups.
A significant statistical difference was found inside group I when comparing means of GCS at admission (11.77 ± 2.02) and at discharge (13.86 ± 1.41) but there was no significant difference between the two groups.
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A significant statistical difference was found inside group I when comparing APACHE II score at admission (10.99 ± 4.16) and at discharge (8.38 ± 2.21) while no significant difference was found between the two groups.
Our results showed that there was a significant difference between the two groups as regard length of hospital stay between the two groups as group I was ( 5.04 ± 1.83 days) and group II was (8.03 ± 2.45 days) while no significant difference as regard length of ICU stay.
As regard complications, there was a difference in distribution and frequency of each complication between the two groups. High gastric residual volume was more frequent in group II (14%) than in group I (9%), also vomiting occurred more in group II (19%) compared to group I (9%). Meanwhile nausea occurred more in group I (14%) compared to group II (10%).
There is no significant difference between the two groups regarding mortality rate and infectious complications including chest infection, urinary tract infection and wound infection.