[Evaluation of the basal metabolic requirements of patients with grave brain lesions]

Basal metabolism (BM) was studied in 26 patients with a brain lesion treated at the neuro-resuscitation department. The complex of examination methods included dynamic appraisal of total energy expenditure and contribution of carbohydrates, fats, and proteins to the total energy expenditures by indirect calorimetry in combination with tests for daily nitrogen excretion, determination of biochemical indices characterizing BM: total lymphocyte count, concentration of blood total protein, albumin, blood urea nitrogen, and creatinine. It is shown that the character and degree of changes of BM depend on the clinico-neurological features of the disease in the postoperative (posttraumatic) period. Aspontaneity of various genesis leads to reduction of total energy expenditure by 18-25% of the normal values. Increased motor activity and the spasmodic syndrome increase total energy expenditure by 30-50%. Concurrent development of infectious complications increases total energy expenditure and changes its structure at the cost of increase of protein expenditure (proteins become responsible for up to 50% of energy expenditure). Indirect calorimetry in combination with tests for daily nitrogen losses is recommended for the evaluation and correction of BM disorders in patients requiring intensive therapy.