Metabolic Response and Nutritional Support in Traumatic Brain Injury: Evidence for Resistance to Renutrition

Charrueau, Christine; Belabed, Linda; Besson, Valérie; Chaumeil, Jean‐Claude; Cynober, Luc; Moinard, Christophe

doi:10.1089/neu.2008.0737

Cited by 34 publications

(34 citation statements)

References 43 publications

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“…One of the consequences of hypermetabolism is a systemic impairment of the immune system, resulting in a serious risk for the development of sepsis. As a consequence, infections are the most common complication following a TBI, affecting 50-75 % of all patients (Charrueau et al 2009). …”

Section: Applications To Critical Care Metabolic Changes In Patients mentioning

confidence: 99%

RETRACTED CHAPTER: Brain Trauma and Nutritional Support

Wetsch¹,

Böttiger²,

Padosch³

2015

Diet and Nutrition in Critical Care

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Section: Applications To Critical Care Metabolic Changes In Patients mentioning

confidence: 99%

RETRACTED CHAPTER: Brain Trauma and Nutritional Support

Wetsch¹,

Böttiger²,

Padosch³

2015

Diet and Nutrition in Critical Care

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“…Bacterial counts were performed on Drigalski agar for enterobacteria, and on Drigalski supplemented with 30 lg/mL kanamycin for E. coli-Xen14. Several organs (jejunum, ileum, liver, extensor digitorum longus [EDL], tibialis, soleus, gastrocnemius, spleen, and thymus) were removed and weighed as previously described (Charrueau et al, 2009).…”

Section: Biological Analysismentioning

confidence: 99%

In VivoBioluminescent Imaging of a New Model of Infectious Complications in Head-Injury Rats

Moinard

Butel

Bureau

et al. 2012

Journal of Neurotrauma

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Infectious complications are responsible for 10-25% of mortality in head-injured patients. In the present work we developed a model of infectious complications in head-injury rats using Escherichia coli (E. coli) with a stable copy of the lux operon, and monitored the infection in vivo by optical imaging. Rats were randomized into three groups: AL (healthy rats), HI (head-injury rats), and HI-EC (HI rats+single enteral bolus of E. coli, 1.3×10(9)/rat given 2 days after HI). Infection was evaluated with a camera at 2 and 6 h after E. coli challenge. Blood and organs were sampled to assess biological parameters. HI was associated with body weight loss, muscle atrophy, and plasma amino acid disturbances, in particular glutamine depletion (AL 919±37 versus HI 647±25 and HI-EC 717±20 μmol/L; p<0.05). In the HI-EC rats, the luminescence signal was observed at T+2 (mean [range]: 34,778 cpm [1617-2,918,810]), and was significantly decreased at T+6 (0 cpm [0-847,922]; p<0.05). Bacterial challenge was associated with a specific body weight loss and a decrease in gastrocnemius protein content, in alanine (AL 512±41 versus HI-EC 395±29 μmol/L; p<0.05), and in sulfur plasma amino acids. In conclusion, we propose a controlled model of HI with infectious complications characterized by specific metabolic alterations. Combined with the in vivo monitoring of the infection by bioluminescence, this model offers a valuable tool to evaluate specific strategies for HI patients.

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“…(19,20) Zinc is an important cofactor for substrates associated with metabolism, the immune system and N-methyl-D-aspartate (NMDA) receptor function. Serum zinc levels are reduced in HT patients, due to the liver sequestration and increased renal clearance.…”

Section: Metabolic Scenariomentioning

confidence: 99%

Terapia nutricional no traumatismo cranioencefálico grave

Campos¹,

Machado

2012

Rev. bras. ter. intensiva

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Terapia nutricional no traumatismo cranioencefálico grave REVIEW ARTICLE INTRODUCTIONHead trauma (HT) continues to be a highly lethal condition, with an overall mortality of 20% to 50% in the United States of America (USA).(1)HT causes 52,000 deaths annually in the USA, with 85% of these deaths occurring within the first two weeks after the trauma.(2) Brazilian statistics on HT are sparse and are only available for specific regions. In São Paulo, the 1997 HT admission rate was 0.36 per 1,000 inhabitants, with an estimated mortality rate of 26 to 39 per 100,000 inhabitants. Currently, strategies for maintaining brain perfusion and preventing hypoxemia, hypotension and intracranial hypertension have reduced the risk of death and improved severe HT outcomes. (4) In spite of the limited data on the relevance of nutrition therapy for HT patients, two systematic Cochrane Collaboration reviews have suggested ABSTRACTThis article reviews the literature, organizes the major findings, and generates the best evidence-based recommendations on nutrition therapy for head trauma patients. Despite recent advances in head trauma diagnosis and therapy, the mortality associated with this condition remains high. Few therapeutic interventions have been proven to effectively improve this condition. Head trauma causes multiple metabolic and electrolytic disorders; it is characterized by a hypermetabolic state that is associated with intensive catabolism, leading to specific nutritional needs.The current literature lacks specific guidelines for nutrition therapy in severe head trauma patients, although a substantial amount of data has been reported and relevant issues are currently being studied; these data may allow better nutrition therapy guidelines for these patients. In addition to a welltrained multi-disciplinary team, the following recommendations appear to improve outcomes: introducing nutrition therapy early; preferred enteral administration; appropriate energy intake; formulations that are tailored to specific patients, including appropriate nutrients; and strict electrolytic and metabolic monitoring. Understanding the pathophysiology and the consequences of therapy is fundamental.

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Metabolic Response and Nutritional Support in Traumatic Brain Injury: Evidence for Resistance to Renutrition

Cited by 34 publications

References 43 publications

RETRACTED CHAPTER: Brain Trauma and Nutritional Support

RETRACTED CHAPTER: Brain Trauma and Nutritional Support

In VivoBioluminescent Imaging of a New Model of Infectious Complications in Head-Injury Rats

Terapia nutricional no traumatismo cranioencefálico grave

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