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BACKGROUND: The resolution of intestinal insufficiency syndrome remains one of the urgent problems of nutritional support for patients with traumatic brain injury (TBI) and chronic critical illness. AIM: To determine the effectiveness of intestinal lavage in restoring the basic functions of the gastrointestinal tract and microbiocenosis in patients with chronic critical illness. MATERIALS AND METHODS: This prospective, randomized, single-center study analyzed 56 men with TBI of various etiologies and chronic critical illness. At the beginning of treatment and on day 10, the effectiveness of gastrointestinal lavage was evaluated as a complex intensive treatment of intestinal insufficiency syndrome. RESULTS: Patients were randomized into two groups depending on the conduct of intestinal lavage. In group 1 (n=27), enteral tube feeding was performed according to the standard method. In group 2 (n=29), intestinal lavage was also performed and an enterosorbent was added to the saline enterosorbent solution, three procedures with an interval of 3 days. A significant positive dynamics of carbohydrate and protein metabolism, restoration by day 10 of the barrier function of the intestine, motility of the gastrointestinal tract, and microbiocenosis were observed in group 2 (main group) compared with those in group 1 (control). CONCLUSION: The inclusion of gastrointestinal lavage in the complex intensive therapy for SCI in patients with a chronic critical illness for a short period helps resolve the main pathogenetic links of SCI restoration of the barrier function of the intestine, digestive transport, motor evacuation processes in the gastrointestinal tract, normalization of microbiocenosis, and metabolic parameters and nutritional status.

In the intensive care unit, along with other methods of intensive care, such as maintaining blood pressure, antibiotic therapy, mechanical ventilation, and vasopressors, clinical nutrition should always be present. Clinical nutrition is an integral part of the treatment process in the intensive care unit. A large number of publications concerning the prevention and treatment of intensive care outcome syndrome exist. One of the most important and low-cost strategies to prevent this condition is nutritional support for critically ill patients at all stages of curation, from the moment of admission to the intensive care unit to the end of the rehabilitation course. With the correct appointment of nutritional support, taking into account the indications and contraindications for various nosological forms, the advantages are obvious in the form of improved treatment outcomes. Proper organization of nutritional support in the hospital is the main key to success in early rehabilitation. From the understanding of nutritional support, its effectiveness will depend on its organization and mutual understanding between all links. Based on the experience of creating a laboratory for clinical nutrition and metabolism, it can be concluded that the creation of such a laboratory and the organization of clinical nutrition in a hospital can improve the results of treatment of even the most severe category of patients.