Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Analysis of gastrointestinal motility trajectory in patients with severe traumatic brain injury.
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Zhang Na, Dou Bei, Sun Chao, Wang Jing, Tan Liping, Mu Qingchun
Аннотация
BACKGROUND: To investigate the changes and predictive factors of gastrointestinal (GI) motility in patients with severe traumatic brain injury (TBI).
METHODS: A total of 118 patients with severe TBI were enrolled, and their GI motility index was monitored daily using ultrasound starting from the initiation of enteral nutrition. Monitoring was performed every 6 h for 5 consecutive days. A latent class growth model was applied to analyze and fit the trajectory of GI motility changes, and multiple logistic regression was used to identify predictive factors associated with different trajectories.
RESULTS: Two distinct trajectories of GI motility changes were identified, with 84 cases (71.1 %) in the low motility group and 34 cases (28.9 %) in the high motility group. Multivariate logistic regression analysis revealed that the use of potassium and proton pump inhibitors were predictive factors distinguishing the two trajectories (both P < 0.05).
CONCLUSIONS: Patients with severe TBI demonstrate high and low levels of GI motility. Brain edema following TBI may be associated with reduced GI motility, and the use of potassium supplements and proton pump inhibitors was also associated with lower motility. These findings suggest that attention to factors potentially influencing GI motility, along with early enteral nutrition strategies, may be important in the clinical management of patients with severe TBI.
METHODS: A total of 118 patients with severe TBI were enrolled, and their GI motility index was monitored daily using ultrasound starting from the initiation of enteral nutrition. Monitoring was performed every 6 h for 5 consecutive days. A latent class growth model was applied to analyze and fit the trajectory of GI motility changes, and multiple logistic regression was used to identify predictive factors associated with different trajectories.
RESULTS: Two distinct trajectories of GI motility changes were identified, with 84 cases (71.1 %) in the low motility group and 34 cases (28.9 %) in the high motility group. Multivariate logistic regression analysis revealed that the use of potassium and proton pump inhibitors were predictive factors distinguishing the two trajectories (both P < 0.05).
CONCLUSIONS: Patients with severe TBI demonstrate high and low levels of GI motility. Brain edema following TBI may be associated with reduced GI motility, and the use of potassium supplements and proton pump inhibitors was also associated with lower motility. These findings suggest that attention to factors potentially influencing GI motility, along with early enteral nutrition strategies, may be important in the clinical management of patients with severe TBI.