EFFECTIVENESS AND SAFETY OF PARENTERAL NUTRITION IN CRITICALLY ILL PATIENTS WITH INTRACRANIAL HEMORRHAGE
Abstract
BACKGROUND The hypercatabolism syndrome may occur in critically ill patients after the intracranial hemorrhage. Mixed enteral and parenteral nutrition is used to provide nutrition support.
MATERIAL AND METHODS We observed 20 patients with intracranial hemorrhage and consciousness score up to 13 (the Glasgow Coma Scale) in the early postoperative period.
RESULTS Administration of parenteral mixture (“three-in-one”) was followed by the progressive growth of transferrin concentration and did not lead to the signifi cant increase of triglycerides concentration in the blood serum. We also noted that the parenteral nutrition lead to the increase of malonedialdehyde (MDA) in the blood serum above normal levels, but the total serum antioxidant activity was normal.
CONCLUSION The 3-component mixture that contains polyunsaturated fatty acids omega 6/omega 3 — 2.5:1 and olive oil, administered to critically ill patients after intracranial hemorrhage, improves protein metabolism indicators and sustains lipid peroxidation and antioxidant activity in the blood serum.
About the Authors
S. S. Petrikov
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
A. A. Solodov
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
E. V. Klychnikova
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
E. V. Tazina
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
M. A. Godkov
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
A. A. Ryk
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
V. V. Krylov
N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Healthcare Department, Moscow, Russian Federation
Russian Federation
Russian Federation
References
1. Belkin A.A., Leyderman I.N., Petrikov S.S., Titova Yu.V. Nutritivnaya podderzhka v nevrologii i neyrokhirugii [Nutritional support in neurology and neurosurgery].In: Khubutia M.S., Popova T.S., Saltanov A.I., eds. Parenteral’noe i enteral’noe pitanie: nats. rukovodstvo [Parenteral and enteral nutrition]. Moscow: GEOTAR-Media Publ., 2014. Ch. 21. 401–418. (In Russian).
2. Krylov V.V., Petrikov S.S., Belkin A.A. Lektsii po neyroreanimatologii: ucheb. posobie [Lectures on the neuroreanimatology]. Moscow: Meditsina Publ., 2009. 192 p. (In Russian).
3. Solodov A.A., Petrikov S.S., Efremenko S.V., et al. Uspeshnoe lechenie massivnoy tromboembolii legochnoy arterii u bol’noy s razryvom arterial’noy anevrizmy golovnogo mozga [Successful treatment of massive pulmonary embolism in a patient with rupture of a cerebral aneurysm]. Neyrokhirurgiya. 2012; 2: 59–66. (In Russian).
4. Leyderman I.N., Gadzhieva N.Sh., Soldatov A.S., Belkin A.A. Metabolicheskiy monitoring i nutritivnaya podderzhka pri kriticheskikh sostoyaniyakh v neyrokhirurgii i nevrologii: ucheb.-metod. posobie dlya vrachey [Metabolic monitoring and nutritional support in critical States in neurosurgery and neurology]. Yekaterinburg: AMB Publ., 2006. 43 p. (In Russian).
5. Härtl R., Gerber L.M., Ni Q., Ghajar J. Effect of early nutrition on deaths due to severe traumatic brain injury. J Neurosurg. 2008; 109 (1): 50–56.
6. Gavrilov V.B., Gavrilova A.R., Mazhul’ L.M. Analiz metodov opredeleniya produktov perekisnogo okisleniya lipidov v syvorotke krovi po testu s tiobarbiturovoy kislotoy [Analysis methods for the determination of products of lipid peroxidation in serum by the test with thiobarbituric acid]. Voprosy meditsinskoy khimii. 1987; 1: 118–122. (In Russian).
7. Singer P., Berger M.M., Van den Berghe G., et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr. 2009; 28 (4): 387–400.
8. Simpson F., Doig G.S. Parenteral vs enteral nutrition in the critically ill patient: a meta-analysis of trials using the intention to treat principle. Intensive Care Med. 2005; 31 (1): 12–23.
9. Solodov A.A., Petrikov S.S. Iskusstvennaya ventilyatsiya legkikh v komplekse lecheniya bol’nykh s netravmaticheskimi vnutricherepnymi krovoizliyaniyami [The artificial lung ventilation in complex treatment of patients with non-traumatic intracranial hemorrhage]. Neyrokhirurgiya. 2013; 4: 12–15. (In Russian).
10. Casaer M.P., Mesotten D., Hermans G., et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011; 365 (6): 506–517.
11. Heidegger C.P., Berger M.M., Graf S., et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: a randomised controlled clinical trial. Lancet. 2013; 381 (9864): 385– 393.
12. Doig G.S., Simpson F., Sweetman E.A., et al. Early PN Investigators of the ANZICS Clinical Trials Group Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial. JAMA. 2013; 309 (20): 2130–2138.
13. Kreymann K.G., Berger M.M., Deutz N.E., et al. ESPEN Guidelines on Enteral Nutrition: Intensive care. Clin Nutr. 2006; 25 (2): 210–223.
14. Boldyrev A.A. Dvoystvennaya rol’ svobodnoradikal’nykh form kisloroda v ishemicheskom mozge [The dual role of free radical oxygen species in cerebral ischemia]. Neyrokhimiya. 1995; 12 (3): 3–13. (In Russian).
15. Solodov A.A., Petrikov S.S., Klychnikova E.V., et al. Vliyanie normobaricheskoy giperoksii na oksigenatsiyu i metabolizm golovnogo mozga, sostoyanie okislitel’nogo stressa u bol’nykh s subarakhnoidal’nym krovoizliyaniem vsledstvie razryva anevrizmy sosudov golovnogo mozga [Normobaric hyperoxia influence on cerebral oxygenation, metabolism and oxidative stress in patients with nontraumatic subarachnoid hemorrhage due to cerebral aneurysms rupture]. Anesteziologiya i reanimatologiya. 2013; 4: 66–71. (In Russian).
Review
For citations:
Petrikov S.S., Solodov A.A., Klychnikova E.V., Tazina E.V., Godkov M.A., Ryk A.A., Krylov V.V. EFFECTIVENESS AND SAFETY OF PARENTERAL NUTRITION IN CRITICALLY ILL PATIENTS WITH INTRACRANIAL HEMORRHAGE. Russian Sklifosovsky Journal "Emergency Medical Care". 2016;(1):15-20.
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