[Nutritional aspects of cranial trauma]

Abstract

In head-injured patients the nutritional support is aimed to prevent denutrition status usually observed. The adequate amount of calories depends on the basal metabolism (as calculated with the Harris Benedict equation). It has to be increased in case of fever (by a 0.1 factor per degree above 37 degrees C), sepsis (by a 0.1 to 0.2 factor) or when sedation is discontinued (by a 0.3 factor). The increased proteolysis is not modified by the associated treatment and results in an inevitable protein loss, whatever the qualitative change in nutritional support. In clinical practice, the nutritional support has to be adjusted continuously to the needs of the patient, to avoid a more pronounced denutrition due to the summation of daily nutritional deficits.