HN-01450097_Calorie intake and liver function in Neurosurgical Patients at the Intensive Care Unit: A randomized clinical trial

Introduction: Acute Liver failure in critically ill patients (ICU) is associated with high mortality. The aim of this study was to evaluate whether hypocaloric in ICU in the first 7 days of hospitalization could be improved liver function.Methods: This randomized clinical trial was conducted on 560 patients who were admitted to trauma, stroke, and neurosurgery ICUs, and at the end 58 patients were analyzed. Patients in the full calorie group, who had started with 75% of their daily energy expenditure, reached the peak daily energy requirement of 90-100% within 48-72 hours of ICU admission. Patients in the hypocaloric group, enteral feeding started with 30% of the daily energy requirement and reached to 75% within a week. Blood samples were collected from patients at baseline and day 7 of the admission.Results: Mean plasma AST enzyme decreased in the hypocaloric group during the first week of intervention (65.33±75.89 to 57.62±30.98, P=0.594). Mean of serum ALT enzyme levels in the full caloric group showed a significant increase (42.54±25.42 to 90.90±56.02؛ P=0.001) during the first week. No significant difference was observed in serum lipids profiles (triglycerides, total cholesterol, LDL and HDL; P> 0.05) and serum electrolytes between the two groups after a week. Blood glucose was significantly decreased in the hypocaloric group in the first week of admission (161.52±47.95 to 118.57±28.01 ؛ P=0.002) but in the second of week decreased (P=0.005).Conclusion: Nutritional support for Neurosurgical ICU with a gradual increase in energy over a 7-day period led to better liver factors.