Probiotics-enhanced early post-pyloric enteral nutrition improves postoperative gastrointestinal function and cognitive function in patients with severe head injury.

OBJECTIVE

To assess the impact of probiotic-supplemented early post-pyloric feeding on gastrointestinal and cognitive recovery in severe traumatic brain injury (TBI) patients.

METHODS

A total of 252 patients with severe TBI who received treatment at our hospital from 2018 to 2022 were selected and divided into four groups according to the random number table method: standard enteral nutrition, early post-pyloric feeding, standard nutrition with probiotics, and early post-pyloric feeding with probiotics (each n = 63). Gastrointestinal hormones, intestinal barrier markers, nutritional indicators, cognitive function, and clinical prognosis were compared. The 28-day survival rate and influencing factors were analyzed using Kaplan-Meier and Cox regression methods.

RESULTS

The post-pyloric + probiotics group showed the highest motilin levels (177.76 ± 16.94 ng/L) and lowest gastrin, diamine oxidase, and D-lactic acid levels (198.24 ± 29.15 ng/L, 1.17 ± 0.39 kU/L, 0.33 ± 0.10 mg/L). This group also had the best albumin (42.75 ± 3.47 g/L), MoCA (28.03 ± 1.50), and NCSE scores (57.92 ± 5.06) (all P < 0.05). The time to first defecation (4.13 ± 0.42 days) and time to reach feeding target (3.87 ± 0.39 days) were shortest, with the lowest APACHE II (4.71 ± 0.69) and SOFA scores (2.07 ± 0.32). The 28-day survival rate was highest (95.2%), with significantly reduced complications (P < 0.05). Cox regression showed reduced mortality risk with combined post-pyloric nutrition and probiotics (HR = 0.27, P < 0.001).

CONCLUSION

Probiotics-enhanced early post-pyloric enteral nutrition improves gastrointestinal function, cognitive recovery, and survival in severe TBI patients, with significant clinical benefits.