DISASTER MEDICINE No.1 •2023
Metabolic Monitoring in Victims in Emergency Situations with Prolonged Impairment of Consciousness
Nikiforov M.V. 1, Korolev A.A. 1, Leyderman I.N. 2
1 Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, St. Petersburg, Russian Federation
2 Almazov National Medical Research Centre, St. Petersburg, Russian Federation
Summary. Investigation purpose – to assess the metabolic needs in victims in emergency situations (ES) with prolonged impairment of consciousness because of traumatic brin injury (TBJ).
Investigation results and their analysis. Investigation results analysis showed that:
– in comparison with calculated method a usage of the method of undirect calorimetry allow to assess the true needs of energy and to determine a plan of nutritional support in view of conducting of rehabilitation measures for ES victims with prolonged impairment of consciousness which were accommodated in day hospital during medical rehabilitation
– an exact determination of body energy demand is principally important for forming of nutritional support plan. An alimentation of ES patients with prolonged impairment of consciousness was recommended to conduct on the main metabolic rate calculated with a Harrison-Benedict equation usage. There is a necessity of an additional metabolic monitoring during stationary period of rehabilitation taking into account an impact of physical activity on patient organism which provided at the time of curative physical exercises.
Key words: emergency situations, hospital period, medical rehabilitation, metabolic monitoring, metabolic needs, nutritional support, undirect calorimetry, victims with prolonged impairment of consciousness
Conflict of interest. The authors declare no conflict of interest
For citation: Nikiforov M.V., Korolev A.A., Leyderman I.N. Metabolic Monitoring in Victims in Emergency Situations with Prolonged Impairment of Consciousness. Meditsina Katastrof = Disaster Medicine. 2023;1:36-41 (In Russ.). https://doi.org/10.33266/2070-1004-2023-1-36-41
- Korolev A.A., et al. Meditsinskaya Reabilitatsiya = Medical Rehabilitation: Study Guide. Ed. Aleksanin S.S. St. Peterburg Publ., 2014. 184 p. (In Russ.).
- Singer P., Reintam A., Berger M., et al. ESPEN Guideline on Clinical Nutrition in the Intensive Care Unit. Clinical Nutrition. 2019;38;1:48-79. DOI: 10.1016/j.clnu.2018.08.037.
- ESPEN Guidelines on Enteral Nutrition. Clinical Nutrition. 2006;25;2:218-219.
- Weir J.B. New Methods for Calculating Metabolic Rate with Special Reference to Protein Metabolism. J. Physiol. 1949;109:1-9. DOI:10.1113/jphysiol.1949.sp004363.
- Luft V.M., Afonchikov V.S, Dmitriyev A.V., et al. Rukovodstvo po Klinicheskomu Pitaniyu = Clinical Nutrition Guide. Monograph. St. Petersburg Publ., 2016. 492 p. (In Russ.).
- Yaroshetskiy A.I., Vasilyeva S.O., Rezepov N.A., et al. The Use of Indirect Calorimetry to Assess Glucose and Lipid Metabolism During Total Parenteral Nutrition in Surgical Patients: A Pilot Study. Vestnik Intensivnoy Terapii imeni A.I. Saltanova = Annals of Critical Care. 2016;4:12-18 (In Russ.).
- Mochalova Ye.G., Legostayeva L.A., Zimin A.A., et al. The Russian Version of Coma Recovery Scale-Revised — a Standardized Method for Assessment of Patients with Disorders of Consciousness. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = The Korsakov’s Journal of Neurology and Psychiatry. 2018;118:3-2:25–31 (In Russ.).
- Leyderman I.N., Belkin A.A., Rakhimov R.T., et al. The Influence of Verticalization on the Dynamics of the Energy Demand at Rest in Patients with Unresponsive Wakefulness Syndrome. Zhurnal Im. N. V. Sklifosovskogo Neotlozhnaya Meditsinskaya Pomoshch = Russian Sklifosovsky Journal of Emergency Medical Care. 2020;9;3:356–362. DOI: 10.23934/2223- 9022-2020-9-3-356-362 (In Russ.).
The material was received 31.01.23; the article after peer review procedure 10.03.23; the Editorial Board accepted the article for publication 23.03.23