Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial

Abstract This study investigates the effects of adding whey protein powder and Bifidobacterium quadruplex live bacterial tablets to enteral nutrition on nutritional indicators, complications, and prognosis in neurological ICU patients. Between April 2022 and December 2023, 100 patients requiring ent...

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Main Authors: Xia Zhang, Jun Zhang, Zhi-bo You, Guo-fang Zhang, Ya Chen, Xue-jiao Zhou, Yuan-hua Si, Zhong Luo, Zu-cai Xu, Ben-hai Yao, Piao Cao
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-12650-y
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author Xia Zhang
Jun Zhang
Zhi-bo You
Guo-fang Zhang
Ya Chen
Xue-jiao Zhou
Yuan-hua Si
Zhong Luo
Zu-cai Xu
Ben-hai Yao
Piao Cao
author_facet Xia Zhang
Jun Zhang
Zhi-bo You
Guo-fang Zhang
Ya Chen
Xue-jiao Zhou
Yuan-hua Si
Zhong Luo
Zu-cai Xu
Ben-hai Yao
Piao Cao
author_sort Xia Zhang
collection DOAJ
description Abstract This study investigates the effects of adding whey protein powder and Bifidobacterium quadruplex live bacterial tablets to enteral nutrition on nutritional indicators, complications, and prognosis in neurological ICU patients. Between April 2022 and December 2023, 100 patients requiring enteral nutrition in our hospital’s Neurology ICU were randomly assigned to four groups (25 each): EN1 (enteral nutrition only), EN2 (enteral nutrition + Bifidobacterium), EN3 (enteral nutrition + Bifidobacterium + whey protein), and EN4 (enteral nutrition + whey protein). Nutritional indicators (albumin, total protein, prealbumin), complication rates (diarrhea, constipation, gastric issues), prognosis indicators (hospital stay, ventilator use, lung infections, antibiotic use), and APACHE II scores were compared. This study has been approved by the Ethics Committee of the Affiliated Hospital of Zunyi Medical University, NO: KLL-2021-112. We confirm that all experiments were performed in accordance with relevant guidelines and regulations. After 7 days, EN3 and EN4 groups showed significantly improved nutritional indicators compared to EN1, with EN3 outperforming EN2. Diarrhea and gastric mucosal bleeding were less frequent in EN2 and EN3 compared to EN1 and EN4. APACHE II scores improved significantly in EN3 and EN4 post-treatment. EN3 had the lowest pulmonary infection rate and reduced antibiotic use, but hospitalization time differences were not significant across groups. Metabolic indicators showed no significant differences between groups. Supplementing enteral nutrition with whey protein powder and Bifidobacterium quadruplex improves nutritional status, reduces gastrointestinal complications, and enhances prognosis in critically ill neurological patients. Trial registration: ChiCTR2300079322, (30/12/2023); Website where it was obtained: https://www.chictr.org.cn/bin/home
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publishDate 2025-08-01
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spelling doaj-art-6c688dca8b5d428e9e569a3f096ecc352025-08-24T11:23:31ZengNature PortfolioScientific Reports2045-23222025-08-0115111310.1038/s41598-025-12650-yEffects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trialXia Zhang0Jun Zhang1Zhi-bo You2Guo-fang Zhang3Ya Chen4Xue-jiao Zhou5Yuan-hua Si6Zhong Luo7Zu-cai Xu8Ben-hai Yao9Piao Cao10Department of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurosurgery, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Neurology, Affiliated Hospital of Zunyi Medical UniversityAbstract This study investigates the effects of adding whey protein powder and Bifidobacterium quadruplex live bacterial tablets to enteral nutrition on nutritional indicators, complications, and prognosis in neurological ICU patients. Between April 2022 and December 2023, 100 patients requiring enteral nutrition in our hospital’s Neurology ICU were randomly assigned to four groups (25 each): EN1 (enteral nutrition only), EN2 (enteral nutrition + Bifidobacterium), EN3 (enteral nutrition + Bifidobacterium + whey protein), and EN4 (enteral nutrition + whey protein). Nutritional indicators (albumin, total protein, prealbumin), complication rates (diarrhea, constipation, gastric issues), prognosis indicators (hospital stay, ventilator use, lung infections, antibiotic use), and APACHE II scores were compared. This study has been approved by the Ethics Committee of the Affiliated Hospital of Zunyi Medical University, NO: KLL-2021-112. We confirm that all experiments were performed in accordance with relevant guidelines and regulations. After 7 days, EN3 and EN4 groups showed significantly improved nutritional indicators compared to EN1, with EN3 outperforming EN2. Diarrhea and gastric mucosal bleeding were less frequent in EN2 and EN3 compared to EN1 and EN4. APACHE II scores improved significantly in EN3 and EN4 post-treatment. EN3 had the lowest pulmonary infection rate and reduced antibiotic use, but hospitalization time differences were not significant across groups. Metabolic indicators showed no significant differences between groups. Supplementing enteral nutrition with whey protein powder and Bifidobacterium quadruplex improves nutritional status, reduces gastrointestinal complications, and enhances prognosis in critically ill neurological patients. Trial registration: ChiCTR2300079322, (30/12/2023); Website where it was obtained: https://www.chictr.org.cn/bin/homehttps://doi.org/10.1038/s41598-025-12650-yNeurological intensive care unitEnteral nutritionMicroecologicsWhey protein powder
spellingShingle Xia Zhang
Jun Zhang
Zhi-bo You
Guo-fang Zhang
Ya Chen
Xue-jiao Zhou
Yuan-hua Si
Zhong Luo
Zu-cai Xu
Ben-hai Yao
Piao Cao
Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial
Scientific Reports
Neurological intensive care unit
Enteral nutrition
Microecologics
Whey protein powder
title Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial
title_full Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial
title_fullStr Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial
title_full_unstemmed Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial
title_short Effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological ICU patients: a randomized controlled trial
title_sort effects of enteral nutrition protocols on nutritional indicators and prognosis in neurological icu patients a randomized controlled trial
topic Neurological intensive care unit
Enteral nutrition
Microecologics
Whey protein powder
url https://doi.org/10.1038/s41598-025-12650-y
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