Nutrition: Time to Revisit?
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.
KeywordsNutrition Severe TBI Enteral feeding Total parenteral nutrition Glucose control
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