[Enteral-parenteral feeding with high protein content in++ severe cranio-cerebral injuries]

Brain injured patients (BIP) usually have hugh losses of nitrogen in the early posttraumatic period. Investigations on protein catabolism in 10 young male BIP, not being moribund, were performed to answer the question whether N-loss can be minimized by an enteral-parenteral nutrition with high protein content (greater than 2 g protein/kg body weight). N-balance, 24-h urinary excretion of creatinin and 3-methylhistidine were measured for 8 days after the accident. The alimentary regime, being adapted to body weight, included for an adult 70-kg patient the intake of 470 g carbohydrates, 170 g aminoacids/proteins and 45 g fats per day (3040 kcal/day = 12700 kJ/day with 112 kcal/g N = 468 kJ/g N). Laboratory data indicated a stimulated muscle turnover rate and a considerable protein catabolism. The waste of endogenous sources could therefore not be prevented by the presented combined nutritional regime.