The metabolic response to severe head injury.

Abstract:

:Caloric expenditure and nitrogen balance were measured in 14 steroid-treated comatose head-injured patients acutely and up to 28 days after injury. During this period patients were fed with a continuous enteral infusion of a formula containing 2 Kcal/cc and 10 gm nitrogen/liter. Indirect calorimetry was carried out for 102 patient-days. The mean resting metabolic expenditure (RME) for nonsedated nonparalyzed patients was 138% +/- 37% of that expected for an uninjured resting person of equivalent age, sex, and body surface area. Nitrogen excretion was measured for 135 patient-days. The mean excretion was 20.2 +/- 6.4 gm/day. The mean protein caloric contribution was 23.9% +/- 6.7% and was greater than 25% for six patients, compared to normal values of 10% to 15%. Despite hyperalimentation, positive nitrogen balance for any 3-day period was achieved in only seven patients, and required replacement of 161% to 240% of RME with enterally administered formula. Head-injured patients had a metabolic response similar to that reported for patients with burns of 20% to 40% of the body surface.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Clifton GL,Robertson CS,Grossman RG,Hodge S,Foltz R,Garza C

doi

10.3171/jns.1984.60.4.0687

subject

Has Abstract

pub_date

1984-04-01 00:00:00

pages

687-96

issue

4

eissn

0022-3085

issn

1933-0693

journal_volume

60

pub_type

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