Why is early enteral nutrition important in TBI, and when is it usually started?

• A. Supports metabolic demands, reduces infection risk, and improves outcomes; started within 24–72 hours when feasible.
• B. Only for weight gain; started after week.
• C. Increases infection risk; started immediately after injury.
• D. Not necessary in most cases; started never.

Answer: (A)

Early enteral nutrition is important because after a traumatic brain injury the body enters a hypermetabolic, catabolic state that increases energy and protein needs. Providing nutrition through the gut helps preserve gut mucosal integrity, reduces bacterial translocation and systemic infection risk, and supports immune function and healing. Enteral feeding is preferred when the gut works, and starting it early has been associated with better outcomes, including fewer infections and improved recovery. The typical timing is within 24 to 72 hours after injury, as soon as the patient is hemodynamically stable and there are no contraindications to feeding. Practical care includes protecting the airway, elevating the head of the bed, monitoring tolerance, and advancing the feeding rate as tolerated; if aspiration risk is high, post-pyloric feeding can be considered.