Fronchko V. The Peculiarities of Nutrition Support of Patients with Severe Cranium-brain-trauma.

The thesis is dedicated to the solving of scientific task, which consists of increasing the efficiency of treating patients with severe cranium-brain-trauma, which is based on the analysis of the peculiarities of hypercatabolism syndrome progress, protein-energy insufficiency severity. The intensity of catabolic reaction in early post-traumatic period reached 180-220 %. The realization of nutrition treatment protocol provided patients with severe cranium-brain-trauma with gradual daily growth of protein-energy recovery. Early enteral and parenteral nutrition in a complex with intensive care measures reduced the development of stress gastroduodenal bleeding to 8,78 %, (p = 0,02), the infectious-inflammatory complications of respiratory system, ventilator-associated pneumonia, in particular, to 18,48 %, (p= 0,009), endobronchitis to 19,3 %, (p = 0,019), infectious intracranial complications to 3,34 %, (p = 0,07), combined treatment failure to 10,9 % (p= 0,054), multiorgan failure to 16,1 %, (p = 0,01) trophic disorders to 12,96 %, (p = 0,048). The number of complications per one patient has decreased by 1,9 times in comparison with the group of patients with the late start of nutrition therapy. Early prescription of enteral and combined food has reduced the terms of artificial ventilation to 36,27 h, (p = 0,046) and the terms of staying in the intensive care department to 68,5 h, (p = 0,012) and has helped reduce overall mortality to 7 %, (p = 0,43), including 8,56 % in the late period, (p = 0,008).