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

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.