Optimizing Early Nutrition Support in Severe Stroke-2

Prior treatment

• Receiving parenteral nutrition support
• Antibiotics were used within the previous 7 days

Other illness

• Complicated with the disease which only have life expectancy \< 7 days
• Admission with infection signs
• Dementia or severe disability (mRS\>4) before stroke
• Subarachnoid hemorrhage, cerebral arteriovenous malformation

Lab values

• Presence of coexisting medical conditions that could interfere with outcome assessment and/or follow-up (a. advanced cancer; b. severe pulmonary dysfunction \[forced expiratory volume in 1 second \< 50% or/and moderate to severe acute lung injury (PaO2/FiO2)\<200mmHg\]; c. cardiac insufficiency (NYHA class \> I; cardiac structural and/or functional abnormalities such as EF\< 50%, abnormal cardiac chamber enlargement, moderate/severe ventricular hypertrophy, or moderate/severe valvular stenosis); d. Severe liver failure \[Child-Pugh score≥7\]; e. Severe renal failure \[glomerular filtration rate ≤30mL/min or serum creatinine ≥4mg/dL\]

Other

• Contraindications of enteral nutrition
• Currently participating in other clinical trial
• Pregnant woman
• Patient who is considered highly likely not to adhere to the study treatment or follow-up protocol.

• Age≥18 years
• Definite diagnosis of acute stroke (GCS ≤12 or NIHSS≥11)
• The randomized nutritional treatment could be initiated up to 72 hours after symptom onset.
• Any cases of profiles #3 through 5 in Water Swallowing Test or with disorder of consciousness.
• Plan to receive nutritional support treatment for at least 7 days.
• Informed consent.