Skip to main content
SpringerLink
Log in
Book cover

Controversies in Severe Traumatic Brain Injury Management pp 99–105Cite as

Nutrition: Time to Revisit?

  • Chapter
  • First Online:

  • 846 Accesses

Abstract

Severe traumatic brain injury (TBI) leads to a disruption of the normal cerebral metabolic state, and TBI patients enter a hypercatabolic state that increases systemic and cerebral energy requirements. Proper management of nutrition in severe TBI patients is important because it influences clinical outcomes. In this chapter we discuss these controversies in nutritional support of severe TBI patients, as follows: the optimal timing of enteral feeding after injury, the preferred method of enteral feeding, enteral versus parenteral nutrition, glucose control, and the role of vitamins and supplements. In each section we review key studies relevant to each topic and review their implications and remaining uncertainties.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Lopez AD, Murray CCJL. The global burden of disease, 1990–2020. Nat Med. 1998;4:1241–3.

    Article  CAS  Google Scholar 

  2. Härtl R, Gerber LM, Ni Q, Ghajar J. Effect of early nutrition on deaths due to severe traumatic brain injury. J Neurosurg. 2008;109:50–6.

    Article  Google Scholar 

  3. Lepelletier D, Roquilly A, Demeure dit latte D, Mahe PJ, Loutrel O, Champin P, et al. Retrospective analysis of the risk factors and pathogens associated with early-onset ventilator-associated pneumonia in surgical-ICU head-trauma patients. J Neurosurg Anesthesiol. 2010;22:32–7.

    Article  Google Scholar 

  4. Dhandapani S, Dhandapani M, Agarwal M, Chutani AM, Subbiah V, Sharma BS, et al. The prognostic significance of the timing of total enteral feeding in traumatic brain injury. Surg Neurol Int. 2012;3:31.

    Article  Google Scholar 

  5. Taylor SJ, Fettes SB, Jewkes C, Nelson RJ. Prospective, randomized, controlled trial to determine the effect of early enhanced enteral nutrition on clinical outcome in mechanically ventilated patients suffering head injury. Crit Care Med. 1999;27:2525–31.

    Article  CAS  Google Scholar 

  6. Chourdakis M, Kraus MM, Tzellos T, Sardeli C, Peftoulidou M, Vassilakos D, et al. Effect of early compared with delayed enteral nutrition on endocrine function in patients with traumatic brain injury: an open-labeled randomized trial. JPEN J Parenter Enteral Nutr. 2012;36:108–16.

    Article  CAS  Google Scholar 

  7. Acosta-Escribano J, Fernández-Vivas M, Grau Carmona T, Caturla-Such J, Garcia-Martinez M, Menendez-Mainer A, et al. Gastric versus transpyloric feeding in severe traumatic brain injury: a prospective, randomized trial. Intensive Care Med. 2010;36:1532–9.

    Article  Google Scholar 

  8. Grahm TW, Zadrozny DB, Harrington T. The benefits of early jejunal hyperalimentation in the head-injured patient. Neurosurgery. 1989;25:729–35.

    Article  CAS  Google Scholar 

  9. Klodell CT, Carroll M, Carrillo EH, Spain DA. Routine intragastric feeding following traumatic brain injury is safe and well tolerated. Am J Surg. 2000;179:168–71.

    Article  CAS  Google Scholar 

  10. Young B, Ott L, Twyman D, Norton J, Rapp R, Tibbs P, et al. The effect of nutritional support on outcome from severe head injury. J Neurosurg. 1987;67(5):668–76.

    Article  CAS  Google Scholar 

  11. Borzotta AP, Pennings J, Papasadero B, Paxton J, Mardesic S, Borzotta R, et al. Enteral versus parenteral nutrition after severe closed head injury. J Trauma. 1994;37(3):459–68.

    Article  CAS  Google Scholar 

  12. Hadley MN, Grahm TW, Harrington T, Schiller WR, McDermott MK, Posillico DB. Nutritional support and neurotrauma: a critical review of early nutrition in forty-five acute head injury patients. Neurosurgery. 1986;19(3):367–73.

    Article  CAS  Google Scholar 

  13. Rapp RP, Young B, Twyman D, Bivins BA, Haack D, Tibbs PA, et al. The favorable effect of early parenteral feeding on survival in head-injured patients. J Neurosurg. 1983;58(6):906–12.

    Article  CAS  Google Scholar 

  14. Young B, Ott L, Haack D, Twyman D, Combs D, Oexmann JB, et al. Effect of total parenteral nutrition upon intracranial pressure in severe head injury. J Neurosurg. 1987;67(1):76–80.

    Article  CAS  Google Scholar 

  15. Yang M, Guo Q, Zhang X, Sun S, Wang Y, Zhao L, et al. Intensive insulin therapy on infection rate, days in NICU, in-hospital mortality and neurological outcome in severe traumatic brain injury patients: a randomized controlled trial. Int J Nurs Stud. 2009;46(6):753–8.

    Article  Google Scholar 

  16. Bilotta F, Caramia R, Cernak I, Paoloni FP, Doronzio A, Cuzzone V, et al. Intensive insulin therapy after severe traumatic brain injury: a randomized clinical trial. Neurocrit Care. 2008;9(2):159–66.

    Article  CAS  Google Scholar 

  17. Coester A, Neumann CR, Schmidt MI. Intensive insulin therapy in severe traumatic brain injury: a randomized trial. J Trauma. 2010;68:904–11.

    CAS  PubMed  Google Scholar 

  18. Painter TJ, Rickerds J, Alban RF. Immune enhancing nutrition in traumatic brain injury—a preliminary study. Int J Surg. 2015;21:70–4.

    Article  Google Scholar 

  19. Young B, Ott L, Kasarskis E, Rapp R, Moles K, Dempsey RJ, et al. Zinc supplementation is associated with improved neurologic recovery rate and visceral protein levels of patients with severe closed head injury. J Neurotrauma. 1996;13(1):25–34.

    Article  CAS  Google Scholar 

  20. Zarbock SD, Steinke D, Hatton J, Magnuson B, Smith KM, Cook AM. Successful enteral nutritional support in the neurocritical care unit. Neurocrit Care. 2008;9:210–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Rani Patal MD & Guy Rosenthal MD

Authors
  1. Rani Patal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guy Rosenthal MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guy Rosenthal MD .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Penn State University Milton S. Hershey Medical Center, Hershey, PA, USA

    Shelly D. Timmons

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Patal, R., Rosenthal, G. (2018). Nutrition: Time to Revisit?. In: Timmons, S. (eds) Controversies in Severe Traumatic Brain Injury Management. Springer, Cham. https://doi.org/10.1007/978-3-319-89477-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-89477-5_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-89476-8

  • Online ISBN: 978-3-319-89477-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation