The influence of severe malnutrition on rehabilitation in patients with severe head injury

Abstract

Patients with head injury suffering from severe malnutrition exhibit serious complications at the time of admission as well as during rehabilitation treatment. The patients were very difficult to mobilize. The length of stay at the rehabilitation unit was 28 days longer when complicated by malnutrition, than head injuries showing normal nutritional status. These findings underline the importance of adequate nutrition in patients with head injury in both the acute ward and in the rehabilitation unit.

Changes in weight after traumatic brain injury in adult patients: A longitudinal study

“…Monitoring in the longer term might reveal many more metabolic complications, and therefore the extended follow-up of these patients should include weight and metabolic management. The weight loss found in 28% of patients could also have significant somatic consequences, since chronic undernutrition can impair functional recovery 26 .…”

Nutrition Considerations in Traumatic Brain Injury

“…Inadequate nutrition support for TBI patients, even well past the initial injury, may result in malnutrition and muscle wasting. This cachexia increases rehabilitation length of stay, increases the difficulty in mobility and functional rehabilitation, and promotes the development of medical complications such as decubitus ulcers, pneumonia, urinary tract infections, and venous thromboembolism 98 …”

“…This cachexia increases rehabilitation length of stay, increases the difficulty in mobility and functional rehabilitation, and promotes the development of medical complications such as decubitus ulcers, pneumonia, urinary tract infections, and venous thromboembolism. 98 Many TBI patients are not able to take in an adequate volume of fluids orally to meet their daily fluid needs due to impaired swallowing or altered consciousness. As the TBI patient transitions to a less intensive care setting, the calorically dense formula used in the ICU should be gradually converted to a more high-volume, isotonic enteral formula to provide a higher percentage of free water per volume.…”

Impact of paroxysmal sympathetic hyperactivity on nutrition management after brain injury: A case series

“…Optimizing nutrition management has been shown to have a marked influence on outcome after severe TBI [7], with both adequate and earlier nutrition associated with more favourable outcome [8]. A systematic review of the nutrition requirements of severe TBI adult patients revealed an increased caloric demand of 96-160% of the predicted values in this population [9].…”