The effect of Low Dietary Inflammatory Index score formula on
inflammatory, metabolic and clinical outcomes in critically ill
Traumatic Brain Injury patients: A Single-blind randomized controlled
pilot Study
Abstract
Aim: In Traumatic brain injury (TBI) patients, a complex cascade of
inflammatory responses is frequently observed following trauma. Numerous
dietary agents have long been found to have potential in modulating
inflammatory responses. This pilot study, designed an enteral formula
with low inflammatory properties based on the dietary inflammatory index
(DIIĀ®) and evaluated its effect on inflammatory and metabolic factors in
critically ill TBI patients. Methods: This Single-blind randomized
controlled pilot study conducted at the Neurosurgical ICU of Shahid
Kamyab Hospital (Mashhad, Iran). A total of 20 TBI patients were
randomly assigned to receive either low-DII-score or standard formula at
the Intensive Care Unit (ICU). The primary outcomes of the study
included clinical status, inflammatory biomarkers, APACHE II, SAPS II,
SOFA, and NUTRIC scores. Results: The trial groups did not differ
significantly on baseline values. Following 14 days of intervention,
there was a statistically significant decrease in the APACHE II, SAPS
II, and NUTRIC scores and a significant increase in GCS score in the
low-DII-score formula group compared to the standard formula group. Over
two weeks, high sensitivity c-reactive protein (hs-CRP) values -2.73
(95% CI: -3.67, -1.79) mg/dL in the low-DII-score formula group vs.
0.65 (95% CI: -0.29, 1.58) mg/dL in controls. Moreover, the length of
hospital stay was longer for the standard formula group than for the
low-DII-score formula group. Conclusion: The low-DII-score formula
improves inflammatory factors (serum hs-CRP) and metabolic biomarkers
(LDL-c and FBS). Furthermore, clinical outcomes, including the length of
hospital stay and disease severity appear to be enhanced.