Monitoring Nutrition and Glucose in Acute Brain Injury

The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

The metabolic response to injury is well described; however, very little is understood about optimal markers to measure this response. This summary will address the current evidence about monitoring nutritional status including blood glucose after acute brain injury (ABI). An electronic literature search was conducted for English language articles describing the testing, utility, and optimal methods to measure nutritional status and blood glucose levels in the neurocritical care population. A total of 45 articles were included in this review. Providing adequate and timely nutritional support can help improve outcome after ABI. However, the optimal content and total nutrition requirements remain unclear. In addition, how best to monitor the nutritional status in ABI is still being elucidated, and at present, there is no validated optimal method to monitor the global response to nutritional support on a day-to-day basis in ABI patients. Nitrogen balance may be monitored to assess the adequacy of caloric intake as it relates to protein energy metabolism, but indirect calorimetry, anthropometric measurement, or serum biomarker requires further validation. The adverse effects of hyperglycemia in ABI are well described, and data indicate that blood glucose should be carefully controlled in critically ill patients. However, the optimal frequency or duration for blood glucose monitoring after ABI remains poorly defined. There are significant knowledge gaps about monitoring nutritional status and response to nutritional interventions in ABI; these need to be addressed and hence few recommendations can be made. The optimal frequency and duration of blood glucose monitoring need further study.

Original languageEnglish
Pages (from-to)159-167
Number of pages9
JournalNeurocritical Care
Volume21
Issue number2
DOIs
StatePublished - Oct 1 2014

Keywords

  • Brain injury
  • Energy expenditure
  • Glucose
  • Monitoring
  • Nitrogen balance
  • Nutritional assessment

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    The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring (2014). Monitoring Nutrition and Glucose in Acute Brain Injury. Neurocritical Care, 21(2), 159-167. https://doi.org/10.1007/s12028-014-0036-2