Abstract

Functional Recovery and Outcome in Patients With Disorder of Consciousness Treated With Bolus Feeding and Early Verticalization: A Case Series

Pages: 17-24

Category: Short Report

Published Date: 21-05-2025

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Valentina Colombo1*, Pamela Salucci1, Francesca Cesira Cava1, Giuseppe Bonavina1, Alice Rita Portillo1, Elisa Maietti2, Roberto Piperno3

Author Affiliation:

1 Montecatone Rehabilitation Institute, via Montecatone 37, 40026 Imola, Bologna, Italy
2 Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, via Massarenti 9, 40138 Bologna, Italy
3 IRCCS Institute of Neurological Sciences of Bologna, via Altura 3, 40139 Bologna, Italy

Keywords:

Brain injury; Disorder of consciousness; Rehabilitation; Enteral feeding; Aspiration pneu-moniae

Abstract:

Background and Aims: Literature regarding enteral feeding modalities in patients with disorder of consciousness (DOC) secondary to acquired brain injury (ABI) is scant. Complications as gas-tro-esophageal reflux and aspiration pneumonia may be reduced using a correct posture during feeding. The primary aim is to evaluate the incidence of lung infections in DOC patients treated with high-speed intermittent enteral nutrition in a verticalized position. Secondary aims are to describe the impact of this management on patient care, nutritional status, sleep-wake rhythm, and functional status. Methods: In this prospective case series, 8 patients were monitored over 12 weeks and followed up 12 months after ABI. Enteral nutrition was administered starting from a speed of 64 cc/h and increased by 50 cc/h every 3 days. Data included: signs of infection, time in/out of bed, nutritional parameters, polysomnography, disability and cognitive scales. Results: No lung infections occurred. Nutritional status and sleep patterns improved. Time out of bed increased. Cognitive scale scores indicate an improvement in cognitive and disability profile. Conclusion: High-speed enteral nutrition with bolus modality did not increase infection risk and did not interfere with rehabilitation goals. Larger studies are needed to draw conclusive evidence on the management of enteral feeding and posture reconditioning in DOC patients.