Good nutrition is essential for the body to heal from any type of injury, including head injuries. The body's metabolism increases significantly following a moderate to severe head injury as it works to heal the brain, according to the Cochrane Collaboration, an organization that establishes evidence-based practices for medicine. As a person's metabolism and their nutritional requirements increase, providing adequate nutrition is critical to facilitate healing and prevent malnutrition.
Nutrition Support Recommendations
Scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center have shown that early nutrition support via a gastric tube placed into the stomach can make a traumatic brain injury patient up to four times more likely to survive the injury. Nutrition support should be initiated as soon as possible following the head injury to provide the body with adequate nutrition for healing. If the digestive tract is functional, enteral nutrition, or nutrition given via a tube placed into the stomach, is the preferred route. If the digestive tract is not functional, a patient can be fed with IV nutrition, which is also referred to as total parenteral nutrition.
Calorie Requirements
The Congress of Neurological Surgeons states that in the acute phase following a head injury, a patient will require at least 40% more calories than they needed before the injury. The Glasgow Coma Scale, or GCS, is used to assess the severity of head injuries. The more severe the head injury, the more calories a patient may require for healing. Patients with a GCS of 4 to 5 require 50 to 60 calories per kilogram of body weight per day. Patients with a GCS of 6 to 7 require 40 to 50 calories per kilogram of body weight per day. Patients with a GCS of 8 to 12 will require approximately 30 to 35 calories per kilogram of body weight per day.
Protein Requirements
The Congress of Neurological Surgeons states that protein requirements are the highest during the second week following a head injury when catabolism, or the breakdown of protein, is at its highest. Patients will require a minimum of 1.2 to 1.6 grams of protein per kilogram of body weight per day, according to the Congress of Neurological Surgeons, and some patients may even require additional protein for healing. Nitrogen balance studies can be done in the hospital to estimate the amount of protein an individual needs.
Rehabilitation and Nutrition
A person who is recovering from a head injury may encounter some challenges related to nutrition during the rehabilitation process. These challenges may include difficulty with motor skills and difficulty swallowing. A team of specialists including physical therapists, occupational therapists and speech language pathologists can help patients re-learn the skills necessary for eating. Supplemental nutrition can be weaned as the amount of nutrition taken by mouth increases. A registered dietitian can assess the amount the amount of protein and calories a patient is eating to ensure adequate nutrition and promote continued healing.
References
- Congress of Neurological Surgeons: Nutrition in Head Injury
- Brain Injury Association of America: Brain Injury Treatment
- "Journal of Neurosurgery" Effects of Early Nutrition on Deaths Due to Severe Traumatic Brain Injury: Roger Hartel et al.: July 2008
- The Cochrane Collaboration: Nutritional Support for Head-Injured Patients; Perel P; et al.
