Nutritional Intervention After Pediatric Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of long-term physical and psychological disability, and ultimately mortality, in children. In pediatric TBI patients, undernutrition is correlated with higher mortality rates, greater risk of infectious complications, and more severe neurologic outcomes. Nutritional intervention and support are therefore essential in the management of severe TBI since they could promote optimal recovery. This narrative review will provide a comprehensive overview of the metabolic changes, commonly occurring in pediatric TBI patients, in the glucose, lipid, and protein metabolism which further emphasizes the importance of this therapeutic approach. Nutritional interventions in the pediatric care unit (PICU) depend on identifying the patient’s most suitable energy goal and the route and timing of nutrient delivery that leads to better outcomes, in addition to balancing these interventions against the risks associated with nutrition treatment. It will also highlight emerging therapies such as specific diets, including macronutrients, vitamins, and mineral supplementations, that intend to reduce neuroinflammation, immunodeficiency, and metabolic crises, by presenting clinical evidence of their usage benefits in neurologic recovery in TBI patients. This review will summarize the currently available literature on nutrition treatment for children with severe traumatic brain injury (sTBI) and highlight on the gaps for future studies.