Elevated intracranial pressure associated with hypermetabolism in isolated head trauma

  title={Elevated intracranial pressure associated with hypermetabolism in isolated head trauma},
  author={Michael N. Bucci and Ronald E. Dechert and Debra Arnoldi and J. P. Campbell and John E. McGillicuddy and Robert H. Bartlett},
  journal={Acta Neurochirurgica},
SummaryBoth metabolic rate and protein catabolism are known to increase following severe head trauma, but the etiology of this hypermetabolism is unknown. To further investigate the problem, we studied the metabolism of 17 patients with indirect calorimetry who had severe craniocerebral trauma only and who required ICP monitoring for management. Patients were studied daily and immediately after ICP spikes greater than 20 mmHg, prior to treatment with hyperventilation, osmotic diuretics, or… 
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Head Injury: Metabolic, Nutritional, and Energy Considerations
Despite promising experimental and clinical results, there are not yet sufficient clinical trials to make nutritional recommendations in head injury patients, so the development of large trials is mandatory to determine which nutrient, at which dose, would be the most appropriate to positively influence head Injury patients’ outcome.
Energy expenditure and protein requirements after traumatic injury.
  • D. Frankenfield
  • Biology
    Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
  • 2006
Traumatic injury induces hypermetabolism. The degree of hypermetabolism can be variable, depending on the type of injury, the degree of inflammation, body composition, age, and treatment regimens. To
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Thermogenic and metabolic response to amino acid solution in brain-dead patients Beyin ölümü hastalar›nda aminoasit solüsyonlar›na metabolik ve termojenik yan›t
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Thermogenic and metabolic response to amino acid solution in brain-dead patients.


The metabolic response to severe head injury.
Head-injured patients had a metabolic response similar to that reported for patients with burns of 20% to 40% of the body surface, and required replacement of 161% to 240% of RME with enterally administered formula.
Metabolic and nutritional sequelae in the non-steroid treated head injury patient.
Head injury induces a profound traumatic response identified by increased energy expenditure, a negative nitrogen balance, weight loss, hypoalbuminemia, and altered substrate oxidation, which seems to be caused by the head injury alone.
Nutritional Considerations in the Patient with Disabling Brain Disease
Increased nutritional requirements are now recognized as the typical sequellae of head injury, and selective nutritional therapies involving the branched chain amino acids may reduce the attrition of the body cell mass seen in head injury patients.
Enteral hyperalimentation in head injury.
It is demonstrated that high caloric and protein feedings may be delivered for prolonged periods enterally for most patients in the acute phase of head injury with few metabolic complications, and that increasing the nitrogen content of feedings from 14% to 22% may somewhat improve nitrogen retention, although nitrogen equilibrium is seldom achieved.
Nutritional support and neurotrauma: a critical review of early nutrition in forty-five acute head injury patients.
The exaggerated nitrogen excretion experienced by patients fed large nitrogen loads illustrates a problem in achieving nitrogen equilibrium in acute head injured patients.
Measurement of metabolism in multiple organ failure.
Respirometry and indirect calorimetry are helpful for management and essential for nutritional research in critically ill patients and in patients with large caloric deficits.
High protein enteral feedings: a means of achieving positive nitrogen balance in head injured patients.
Data indicate that once enteral formulas are tolerated high nitrogen regimens are required to achieve positive nitrogen balance in acute severe head injury patients.
The Weir formula may be utilized for all practical purposes in lieu of the tables, permitting elimination of the RQ correction factor, and thus simplifying the estimation of the energy cost of activity.