Brain Trauma and Nutritional Support

  • Wolfgang A. Wetsch
  • Bernd W. Böttiger
  • Stephan A. Padosch
Living reference work entry

Abstract

Severe traumatic brain injury is among the most common causes of death in young adults in the industrialized nations. Secondary injury due to an activation of pathophysiological signaling pathways significantly enlarges primary injury directly caused by trauma and is responsible for one third of all fatalities due to traumatic brain injury. Critical care medicine in patients with traumatic brain injury aims to minimze secondary injury and further loss of potentially healthy brain tissue, to prevent activation of proinflammatory cascades, and to minimize the consequences of these cascades. Therapeutic strategies include continuous monitoring and avoidance of raised intracranial pressure, arterial hypotension, hypoxemia, and thromboembolic complications. Nutrition and its effects on the outcome of severe traumatic brain injury have been underestimated for a long time. There is evidence that nutrition should be started within the first 24 h after traumatic brain injury. If no contraindications exist, the enteral route should be the preferred way for administering nutrition. When nutrition is started already with full calculated calories on the first day after trauma, infections and overall complications can be reduced significantly.

Keywords

Zinc Phosphorus Starch Magnesium Glutamine 

Abbreviations

ADH

Antidiuretic hormone

CNS

Central nervous system

CPM

Central pontine myelinolysis

CPP

Cerebral perfusion pressure

CSWS

Cerebral salt-wasting syndrome

CVP

Central venous pressure

ECG

Electrocardiography

ESPEN

European Society for Clinical Nutrition and Metabolism

GCS

Glasgow Coma Scale

HES

Hydroxyethyl starch

ICP

Intracranial pressure

ICU

Intensive care unit

LCT

Long-chain triglycerides

MCT

Medium-chain triglycerides

ROS

Reactive oxygen species

SIADH

Syndrome of inappropriate antidiuretic hormone secretion

SOP

Standard operating procedure

TBI

Traumatic brain injury

VAP

Ventilator-associated pneumonia

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Wolfgang A. Wetsch
    • 1
  • Bernd W. Böttiger
    • 1
  • Stephan A. Padosch
    • 1
  1. 1.Department of Anaesthesiology and Intensive Care MedicineUniversity Hospital of CologneCologneGermany

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