Nutritional Support In Severe Traumatic Brain Injury Treatment

The earliest study of metabolic changes in the severe acute brain damage was reported in 1975. Today, enteral nutrition and exteral nutrition are wildly clinical used in western countries. In China, the study of nutritional support of severe head injured patients started at 1980's. Until recently, most of the studies are only limited in clinical observations.Nutrition assessment is to estimate the nutritional status by body measurement, body composition, biochemical measurement and clinical check, total lymphocyte count(TLC), skin delayed hypersensitivity(SDH), and other ways. Nutrition assessment is usually used to estimate degrees of malnutrition and the results of nutritional support. Malnutrition usually points to protein energy malnutrition (PEM),includes adult maramus, Kwashiorkor and mixed marasmus and malnutrutiion.Metabolic changes of head injured patients mainly include :highly catabolism, disturbance of carbohydrate metabolism, negative nitrogen balance. The aim of nutritional support of severe head injured patients is metabolic support and metabolic adjustment. Metabolic support requests 35kcal/day energy supply and 10-15g protein supply every day. Parenteral nutrition is only used in early head injured patients with gastrointestinal function problems. Enteral nutrition is used in most patients.The main problems : It is difficult to estimate the really energy consumption of severe head injured patients. The results usually different from the really status; Basic studies are still not enough yet ; Clinically results of nutritional support therapy of severe head injured patients are still not certain.