Document Detail

Nutritional considerations in the patient with disabling brain disease.
MedLine Citation:
PMID:  3923386     Owner:  NLM     Status:  MEDLINE    
Increased nutritional requirements are now recognized as the typical sequellae of head injury. Whether similar nutritional demands routinely accompany nontraumatic, disabling brain diseases is uncertain. Experience with patients suffering from head injury indicates that clinical criteria for differentiating the severity of neurological impairments categorize rather poorly the levels of nutritional need. Based on available data, "nutritional risk" can only be assigned to broad patient categories. Head-injured patients seem to be at nutritional risk and, by virtue of increased caloric and protein requirements, may benefit, in terms of reduced mortality, from early, intensive nutritional intervention. Because the nutritional risk cannot be established, the indications for aggressive nutritional support in the noninjured patient are even less clear than those for the trauma patient. Parenteral nutrition is often required to meet the goals of nutritional support because inadequacies in gastrointestinal function frequently mitigate successful enteral nutrition. Selective nutritional therapies involving the branched chain amino acids may reduce the attrition of the body cell mass seen in head injury patients. Furthermore, improvements in energy nutrient utilization in other than head-injured patients have been suggested when fat is provided in addition to glucose as a caloric source. When clinically feasible, enteral nutrition offers significant economic and physiological benefits over parenteral nutrition. In this regard, increasing attention has been focused on newer techniques of enteral access. These include percutaneous gastrostomies and nasally inserted small bore feeding tubes. The latter achieve duodenal intubation with a high success rate, and they offer the prospects of improved feeding tolerance and reduced tracheobronchial aspiration by allowing the administration of nutrients distal to the pylorus.(ABSTRACT TRUNCATED AT 250 WORDS)
W W Turner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  16     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1985 May 
Date Detail:
Created Date:  1985-07-17     Completed Date:  1985-07-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  707-13     Citation Subset:  IM    
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MeSH Terms
Amino Acids / administration & dosage
Blood Proteins / metabolism
Brain Diseases / surgery*
Energy Metabolism
Enteral Nutrition / methods*
Fat Emulsions, Intravenous / administration & dosage
Nutritional Requirements
Parenteral Nutrition / methods*
Postoperative Care
Preoperative Care
Surgical Wound Infection / therapy
Reg. No./Substance:
0/Amino Acids; 0/Blood Proteins; 0/Fat Emulsions, Intravenous

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