Email this article The impact of early enteral nutrition on the acute phase of severe psychoactive substance poisoning: a prospective randomized clinical study
- Authors: Yashin N.A.1, Volobueva N.S.1, Kosova A.L.2, Arsentiev L.V.1, Strukov E.Y.1, Lakhin R.E.1, Shchegolev A.V.1
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Affiliations:
- Kirov Military Medical Academy
- Main Military Clinical Hospital named after academician N.N. Burdenko
- Issue: Vol 6, No 4 (2025)
- Pages: 181-188
- Section: Original Study Articles
- URL: https://journals.rcsi.science/2658-4433/article/view/375544
- DOI: https://doi.org/10.17816/clinutr698464
- EDN: https://elibrary.ru/XHOFLI
- ID: 375544
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Full Text
Abstract
BACKGROUND: Enteral nutrition during the acute phase of poisoning with psychoactive substances is an integral component of intensive care. However, its effectiveness remains understudied.
AIM: This study aimed to evaluate the effectiveness of early enteral nutrition in patients with severe acute poisoning by psychoactive substances.
METHODS: The study included 36 patients treated in the intensive care unit (ICU) for acute poisoning with psychoactive substances. Patients were randomized into two groups. In the first (main) group, enteral nutrition was initiated within 24 hours of ICU admission. In the control group, enteral nutrition was started after 36 hours. In all patients, neurological status trends were assessed using the FOUR (Full Outline of UnResponsiveness) score; the number of days to liberation from mechanical ventilation and ICU length of stay were recorded. Plasma albumin and total protein concentrations were also analyzed.
RESULTS: On day 3, neurological deficit in the control group was 12 (10; 14) points on the FOUR scale. This indicator was significantly lower than in the main group—15 (14; 16) points (p = 0.006). No significant differences between groups were observed on day 1.
Plasma total protein and albumin concentrations did not differ between groups on day 1. By day 3, total protein concentration was significantly higher in the main group (62.48 ± 5.77 g/L) compared with the control group (55.34 ± 5.28 g/L, p = 0.001). Albumin concentration was also higher in the main group: 39.55 ± 3.75 g/L vs 34.48 ± 4.51 g/L (p = 0.002). No significant association was found between the timing of enteral nutrition initiation and the duration of mechanical ventilation or ICU stay.
CONCLUSION: Early enteral nutrition in patients with severe poisoning by psychoactive substances significantly increases plasma albumin and total protein levels and contributes to faster neurological recovery. No significant effect of enteral nutrition timing on ICU length of stay or duration of mechanical ventilation was observed.
About the authors
Nikita A. Yashin
Kirov Military Medical Academy
Email: nikitayashin17031998@gmail.com
ORCID iD: 0009-0002-8052-6012
Russian Federation, Saint Petersburg
Natalia S. Volobueva
Kirov Military Medical Academy
Email: ns8855290@gmail.com
ORCID iD: 0009-0007-2949-8462
SPIN-code: 7550-0993
Russian Federation, Saint Petersburg
Anastasia L. Kosova
Main Military Clinical Hospital named after academician N.N. Burdenko
Email: nastja-7@yandex.ru
ORCID iD: 0009-0009-9947-214X
Russian Federation, Moscow
Leonid V. Arsentiev
Kirov Military Medical Academy
Email: arsentevlvmd@gmail.com
ORCID iD: 0000-0002-5886-9900
SPIN-code: 8514-7396
MD, Cand. Sci. (Medicine)
Russian Federation, Saint PetersburgEgor Yu. Strukov
Kirov Military Medical Academy
Author for correspondence.
Email: e.strukov@mail.ru
ORCID iD: 0000-0001-5041-1201
SPIN-code: 3949-3704
MD, Dr. Sci. (Medicine), Assistant Professor
Russian Federation, Saint PetersburgRoman E. Lakhin
Kirov Military Medical Academy
Email: doctor-lahin@yandex.ru
ORCID iD: 0000-0001-6819-9691
SPIN-code: 7261-9985
MD, Dr. Sci. (Medicine), Assistant Professor
Russian Federation, Saint PetersburgAleksei V. Shchegolev
Kirov Military Medical Academy
Email: alekseischegolev@gmail.com
ORCID iD: 0000-0001-6431-439X
SPIN-code: 4107-6860
MD, Dr. Sci. (Medicine), Professor
Russian Federation, Saint PetersburgReferences
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