Article Sidebar

PDF
Issue: Vol. 565 No. 1 (2026)
Section: Các bài báo
DOI: 10.51298/vmj.v565i1.19196
Date Published: 03/11/2026
Views 79
Downloads 46
How to Cite
Trần, A. Đ. (2026). COMPARISON OF OUTCOMES BEFORE AND AFTER IMPLEMENTATION OF AN EARLY NUTRITION PROTOCOL IN SURGICALLY TREATED PATIENTS WITH RUPTURED ANTERIOR CIRCULATION CEREBRAL ANEURYSMS. Vietnam Medical Journal, 565(1). https://doi.org/10.51298/vmj.v565i1.19196

COMPARISON OF OUTCOMES BEFORE AND AFTER IMPLEMENTATION OF AN EARLY NUTRITION PROTOCOL IN SURGICALLY TREATED PATIENTS WITH RUPTURED ANTERIOR CIRCULATION CEREBRAL ANEURYSMS

Anh Đức Trần1,
1 Học viện Quân y

Main Article Content

Abstract

Objective: To compare nutritional indices, complications, and treatment outcomes before and after implementation of an early individualized nutrition protocol in patients undergoing surgical clipping for ruptured anterior circulation aneurysms.


Subjects and methods: This retrospective before-after cohort included 93 patients treated at Military Hospital 103. The post-implementation group (n=45; October 2024-May 2026) received individualized nutritional support initiated within 24-48 hours after surgery, whereas the pre-implementation group (n=48; January 2021-September 2024) received routine nutritional care.


Results: From postoperative day 7 onward, albumin, prealbumin, total protein, and nitrogen balance showed more favorable values at several time points in the post-implementation group. Mechanical ventilation (4.8 vs 7.1 days; p<0.001), ICU stay (7.2 vs 10.4 days; p<0.001), and hospital stay (18.2 vs 22.1 days; p=0.011) were shorter. Nosocomial pneumonia (13.3% vs 29.2%; p=0.063), good GOS at discharge (46.7% vs 27.1%; p=0.050), and mRS ≤2 at 3 months (53.3% vs 33.3%; p=0.052) showed favorable trends without reaching statistical significance.


Conclusion: After implementation of the early individualized nutrition protocol, nutritional trajectories and selected resource-use outcomes were more favorable. Effects on complications and neurological recovery require confirmation in prospective controlled studies.

Keywords

ruptured cerebral aneurysm, early nutrition, treatment outcome

Article Details

References

1. Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet. 2017;389(10069):655-666.
2. Connolly ES, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(6):1711-1737.
3. Badjatia N, Monahan A, Carpenter A, et al. Inflammation, negative nitrogen balance, and outcome after aneurysmal subarachnoid hemorrhage. Neurology. 2015;84(7):680-687.
4. Diringer MN, Bleck TP, Hemphill JC 3rd, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference. Neurocrit Care. 2011;15(2):211-240.
5. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79.
6. Kasuya H, Kawashima A, Namiki K, et al. Metabolic profiles of patients with subarachnoid hemorrhage treated by early surgery. Neurosurgery. 1998;42(6):1268-1274.
7. Elke G, van Zanten AR, Lemieux M, et al. Enteral versus parenteral nutrition in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials. Crit Care. 2016;20(1):117.