Summary of the Best Evidence for Enteral Nutrition Support in Adults with Severe Brain Injury

Background Enteral nutrition support can effectively improve the nutritional status of patients with severe brain injury, which is beneficial to the prognosis of patients. However, the relevant literature in China and abroad lacks a systematic nutritional management plan for such patients, and there is rare summary of the best evidence for enteral nutrition support. Objective To retrieve and summarize the best evidence of enteral nutrition support in adult patients with severe brain injury, and provide evidence-based evidence for the clinical nutrition management of such patients. Methods All evidence on enteral nutrition in adult patients with severe brain injury was retrieved from databases and websites including BMJ Best Practice, Up To Date, GIN, NICE, NGC, RNAO, Yimaitong, ESPEN, ASPEN, SCCM, ESICM, JBI Library, Cochrane Library, PubMed, EMBase, CINAHL, CBM, CNKI, Wanfang Data, VIP. The retrieved evidence included guidelines, evidence summaries, best practices, expert consensus, systematic reviews and meta-analysis. The retrieval period was from April 2011 to April 2021. Corresponding quality evaluation criteria were used to evaluate the quality of the included literature, and the evidence was described and summarized using the JBI Evidence-based Health Care Center Evidence Pre-grading System (2014 edition) and JBI Evidence Recommendation Rating System (2014 edition) . Results A total of 18 articles were included, including 5 clinical guidelines, 3 evidence summaries, 3 expert consensus, 2 systematic reviews, and 5 meta-analysis. Their methodological qualities were rated high overall. Finally 25 pieces of best evidence involving 8 aspects were nutrition screening, nutrition assessment, timing of initiating enteral nutrition, energy and protein requirements, enteral nutrition composition, feeding route, infusion method and complication management. Conclusion When giving enteral nutrition to adult patients with severe brain injury, medical staff need to implement it based on the best evidence. At the same time, an individualized enteral nutrition support program should be formulated in combination with the current medical status and specific treatment goals in China to improve the effect of nutritional support, thereby improving the clinical outcome of patients.