The metabolic response to severe head injury

G. L. Clifton, C. S. Robertson, Robert G. Grossman, S. Hodge, R. Foltz, C. Garza

Research output: Contribution to journalArticlepeer-review

189 Scopus citations


Caloric expenditure and nitrogen balance were measured in 14 steroid-treated comatose head-injured patients acutely and up to 28 days after injury. During this period patients were fed with a continuous enteral infusion of a formula containing 2 Kcal/cc and 10 gm nitrogen/liter. Indirect calorimetry was carried out for 102 patient-days. The mean resting metabolic expenditure (RME) for nonsedated nonparalyzed patients was 138% ± 37% of that expected for an uninjured resting person of equivalent age, sex, and body surface area. Nitrogen excretion was measured for 135 patient-days. The mean excretion was 20.2 ± 6.4 gm/day. The mean protein caloric contribution was 23.9% ± 6.7% and was greater than 25% for six patients, compared to normal values of 10% to 15%. Despite hyperalimentation, positive nitrogen balance for any 3-day period was achieved in only seven patients, and required replacement of 161% to 240% of RME with enterally administered formula. Head-injured patients had a metabolic response similar to that reported for patients with burns of 20% to 40% of the body surface.

Original languageEnglish (US)
Pages (from-to)687-696
Number of pages10
JournalJournal of Neurosurgery
Issue number4
StatePublished - 1984

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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