Assessment of need in nutritional support in patients with the consequences of central nervous system injuries

Gumarova L.Sh.; Bodrova R.A.

doi:https://doi.org/10.17116/jnevro20161163183-87

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Abstract:

Traumatic brain injury (TBI) and spinal cord injury (SCI) are most common causes of death and disability in young patients. Metabolic changes occur immediately after the acute injury of the central nervous system. However hypermetabolic response in SCI is less pronounced compared to that in TBI that could be explained by the weakness of denervated muscles and hypodynamia. Following SCI, the level of resting energy expenditure is lower comparison to that calculated using the Harris—Benedict formula. Indirect calorimetry corresponded to class II (B) medical evidence, is recommended as a method for assessment of energy expenditure in the acute stage of TBI and SCI as well as in their consequences. Nutritional support is favorable and safe and therefore, it should be used as soon as possible. Many studies provide evidence that nutritional support leads to the replenishment of energy expenditure, reduce catabolic processes and nitrogen loss thus minimizing the risk of complications that in future decrease the extent of disability and increase quality-of-life of patients with the consequences of central nervous system injuries.

Keywords:

traumatic brain injury

spinal cord injury

metabolic disorders

nutritional support

Authors:

Gumarova L.Sh.

Kazan State Medical Academy, Kazan

Bodrova R.A.

Kazan State Medical Academy, Kazan

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References:

Sokolov VA. Mnozhestvennye i sochetannye travmy. M. 2006. (In Russ.).
Giacino JT. Placebo-controlled trial of amantadine for severe traumatic brain injury. N Engl J Med. 2012;366(9):819-826. doi: 10.1056/NEJMoa1102609.
Rosenfeld JV. Early management of severe traumatic brain injury. Lancet. 2012;380(9847):1088-1098. doi: 10.1016/S0140-6736(12)60864-2.
Furlan JC, Sakakibara BM, Miller WC, Krassioukov AV. Global incidence and prevalence of traumatic spinal cord injury. Can J Neurol Sci. 2013;40(4):456-464. doi: 10.1017/S0317167100014530.
Cruse JM, Lewis RE, Roe DL. Facilitation of immune function, healing of pressure ulcers, and nutritional status in spinal cord injury patients. Exp Mol Pathol. 2000;68(1):38-54. doi: 10.1006/exmp.1999.2292.
Riley KO, May AK, Hadley MN. Neurological injury and nutritional support. In: Batjer HH, Loftus CM, eds. Textbook of Neurological Surgery: Principles and Practice. Philadelphia, PA: Lippincott Williams and Wilkins; 2001.
Black PMcL., Daniel L. Complications and Sequelae of Head Injury. Barrow Thieme. 1992.
Wong S, Derry F, Jamous A, Hirani SP, Grimble G, Forbes A. The prevalence of malnutrition in spinal cord injured patients — a UK multicenter study. Br J Nutr. 2011;108:918-923. doi: 10.1017/s0007114511006234.
Wong S, Derry F, Jamous A, Hirani SP, Grimble G, Forbes A. Profile and prevalence of malnutrition in children with spinal cord injuries — assessment of the Screening tool for Assessment in Paediatrics (STAMP). Spinal Cord. 2011;50:67-71. doi: 10.1038/sc.2011.139.
Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J. Malnutrition is an independent factor associated with the nosocomial infections. Br J Nutr. 2004;92:105-111. doi: 10.1079/bjn20041152.
Ho CH, Powell HL, Collins JF, Bauman WA, Spungen AM. Poor nutrition is a relative contraindication to negative pressure wound therapy for pressure ulcers: preliminary observations in patients with spinal cord injury. Adv Skin Wound Care. 2010;23:508-516. doi: 10.1097/01.asw.0000390493.43835.ec.
National Institute of Health and Clinical Excellence. The management of pressure ulcers in primary and secondary care: A clinical practice guideline. No 29. NICE: London, UK. 2005.
National Institute of Health and Clinical Excellence. Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition. No 32. NICE: London, UK. 2006.
Sorensen J, Kondrup J, Prokopowicz J, Schiesser M, Krahenbihl L, Meier R. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr. 2008;27:340-349. doi: 10.1016/j.clnu.2008.03.012.
Cook AM, Holt E, Peppard A, Magnuson B. Nutrition considerations in traumatic brain injury. Nutrition in Clinical Practice. 2008;23(6):608-620. doi: 10.1177/0884533608326060.
Frankenfield DC, Smith JS, Cooney RN. Accelerated nitrogen loss after traumatic injury is not attenuated by achievement of energy balance. JPEN J Parenter Enteral Nutr. 1997;21(6):324-329. doi: 10.1177/0148607197021006324.
Hadley M. Hypermetabolism following head trauma: nutritional considerations. In: Barrow D, ed. Complications and Sequelae of Head Injury (Neurosurgical Topics series). Park Ridge, IL: AANS; 1992;161-168.
Cruse JM, Lewis RE, Dilioglou S, Roe DL, Wallace WF, Chen RS. Review of immune function, healing of pressure ulcers, and nutritional status in patients with spinal cord injury. J Spinal Cord Med. 2000;23(2):129-135.
Hulsewé KW, van Acker BA, von Meyenfeldt MF, Soeters PB. Nutritional depletion and dietary manipulation: Effects on the immune response. World J Surg. 1999;23(6):536-544. doi: 10.1007/pl00012344.
Dhall SS, Hadley MN, Aarabi B, Gelb DE, Hurlbert RJ. Nutritional support after spinal cord injury. Neurosurgery. 2013;72:255-259. doi: 10.1227/neu.0b013e31827728d9.
Kaufman HH, Rowlands BJ, Stein DK, Kopaniky DR, Gildenberg PL. General metabolism in patients with acute paraplegia and quadriplegia. Neurosurgery. 1985;16(3):309-313. doi: 10.1227/00006123-198503000-00005.
Kearns PJ, Thompson JD, Werner PC, Pipp TL, Wilmot CB. Nutritional and metabolic response to acute spinal-cord injury. JPEN J Parenter Enteral Nutr. 1992;16(1):11-15. doi: 10.1177/014860719201600111.
Rodriguez DJ, Benzel EC, Clevenger FW. The metabolic response to spinal cord injury. Spinal Cord. 1997;35(9):599-604. doi: 10.1038/sj.sc.3100439.
Rodriguez DJ, Benzel EC, Clevenger FW. Nutritional support. In: Benzel EC, ed. Spine Surgery: Techniques, Complication Avoidance, and Management. Vol 2. New York, NY: Churchill Livingstone; 1999;1321-1331.
Young B, Ott L, Twyman D. The effect of nutritional support on outcome from severe head injury. J Neurosurg. 1987;67(5):668-676. doi: 10.3171/jns.1987.67.5.0668.
Grahm TW, Zadrozny DB, Harrington T. The benefits of early jejuna hyperalimentation in the head-injured patient. Neurosurgery. 1989;25(5):729-735. doi: 10.1227/00006123-198911000-00007.
Hadley MN. Hypermetabolism after CNS trauma: arresting the «injury cascade». Nutrition. 1989;5(2):143.
Hadley MN, Grahm TW, Harrington T, Schiller WR, McDermott MK, Posillico DB. Nutritional support and neurotrauma: A critical review of early nutrition in forty-five acute head injury patients. Neurosurgery. 1986;19(3):367-373. doi: 10.1227/00006123-198609000-00006.
Rapp RP, Young B, Twyman D. The favorable effect of early parenteral feeding on survival in head-injured patients. J Neurosurg. 1983;58(6):906-912. doi: 10.3171/jns.1983.58.6.0906.
Young B, Ott L, Rapp R, Norton J. The patient with critical neurological disease. Crit Care Clin. 1987;3(1):217-233.
Titova JuV, Krylov VV, Petrikov SS. Sravnitel'nyj analiz opredelenija jenergopotrebnosti bol'nyh s vnutricherepnymi krovoizlijanijami pri pomoshhi uravnenija Harrisa—Benedikta i neprjamoj kalorimetrii. Vserossijskaja nauchno-prakticheskaja konferencija «Polenovskie chtenija»; Aprel' 24—27, 2013; Sankt-Peterburg. Dostupno po: http://congress-ph.ru/istorija_1_1/2013_god/polenov13. Ssylka aktivna na 18.05.15. (In Russ.).
Carey ME, Nance FC, Kirgis HD, Young HF, Megison LC Jr, Kline DG. Pancreatitis following spinal cord injury. J Neurosurg. 1977;47(6):917-922. doi: 10.3171/jns.1977.47.6.0917.
Barboriak JJ, Rooney CB, El Ghatit AZ, Spuda K, Anderson AJ. Nutrition in spinal cord injury patients. J Am Paraplegia Soc. 1983;6(2):32-36.
Clarke KS. Caloric costs of activity in paraplegic persons. Arch Phys Med Rehabil. 1966;47(7):427-435.
Cox SA, Weiss SM, Posuniak EA, Worthington P, Prioleau M, Heffley G. Energy expenditure after spinal cord injury: An evaluation of stable rehabilitating patients. J Trauma. 1985;25(5):419-423. doi: 10.1097/00005373-198505000-00008.
Levine AM, Nash MS, Green BA, Shea JD, Aronica MJ. An examination of dietary intakes and nutritional status of chronic healthy spinal cord injured individuals. Paraplegia. 1992;30(12):880-889. doi: 10.1038/sc.1992.165.
Peiffer SC, Blust P, Leyson JF. Nutritional assessment of the spinal cord injured patient. J Am Diet Assoc. 1981;78(5):501-505.
Kolpek JH, Ott LG, Record KE. Comparison of urinary urea nitrogen excretion and measured energy expenditure in spinal cord injury and nonsteroid treated severe head trauma patients. JPEN J Parenter Enteral Nutr. 1989;13(3):277-280. doi: 10.1177/0148607189013003277.
Rowan CJ, Gillanders LK, Paice RL, Judson JA. Is early enteral feeding safe in patients who have suffered spinal cord injury? Injury. 2004;35(3):238-242. doi: 10.1016/s0020-1383(03)00203-1.
Belova AN, Prokopenko SV. Nejroreabilitacija. 3-e izd., pererab. i dop. M. 2010. (In Russ.).
Reabilitacija bol'nyh s travmaticheskoj bolezn'ju spinnogo mozga. Pod obshh. red. Ivanovoj GE, Krylova VV, Cykunova MB, Poljaeva BA. M.: Izdatel'stvo Moskovskie uchebniki i kartolitografija; 2010. (In Russ.).
Protokol vedenija bol'nyh s posledstvijami travm spinnogo mozga v vosstanovitel'nom i pozdnem periodah. Dostupno po: http://rudoctor.net/medicine2009/bz-sw/med-rmiav/index.htm. Ssylka aktivna na 18.05.15. (In Russ.).
Dvorak MF, Noonan VK, Bélanger L. Early versus late enteral feeding in patients with acute cervical spinal cord injury: A pilot study. Spine (Phila Pa 1976). 2004;29(9):175-180.
Nutritional support after spinal cord injury. In: Guidelines for the management of acute cervical spine and spinal cord injuries. Neurosurgery. 2002;50(3 suppl):81-84.
Sedlock DA, Laventure SJ. Body composition and resting energy expenditure in long term spinal cord injury. Paraplegia. 1990;28(7):448-454. doi: 10.1038/sc.1990.60.