Nutritional and metabolic response to acute spinal-cord injury.

The metabolic response to complete spinal cord injury was prospectively studied in 10 patients with Frankel class A spinal cord injury. Weekly excretory and balance studies profile the changes in nitrogen, calcium, and 3-methylhistidine excretion in relation to body weight and metabolic rate. The initial resting energy expenditures were 10% below what was predicted, and body weight decreased by 10%. Nitrogen excretion paralleled the changes in body weight. Calcium excretion increased for 3 weeks and reached a plateau 150% above baseline. Our results chronicle the magnitude of metabolic response to spinal shock. Comparison with reported values shows this response exceeds that seen in immobilized patients. Nitrogen excretion rose to levels seen in highly stressed patients and must be considered in the management of patients with acute spinal-cord injury.

[1]  F. Schønheyder,et al.  Creatinuria due to immobilization in bed. , 2009, Acta medica Scandinavica.

[2]  J. Kinney,et al.  Parenteral nutrition in septic patients: effect of increasing nitrogen intake. , 1987, The American journal of clinical nutrition.

[3]  M. Patricot,et al.  Effects of intermittent electrical stimulations on muscle catabolism in intensive care patients. , 1987, JPEN. Journal of parenteral and enteral nutrition.

[4]  K. Segal.  Comparison of indirect calorimetric measurements of resting energy expenditure with a ventilated hood, face mask, and mouthpiece. , 1987, The American journal of clinical nutrition.

[5]  F. Ballard,et al.  3-Methylhistidine as a measure of skeletal muscle protein breakdown in human subjects: the case for its continued use. , 1983, Clinical science.

[6]  L. Halstead,et al.  Metabolic and endocrine changes in spinal cord injury: IV. Compounded neurologic dysfunctions. , 1982, Archives of physical medicine and rehabilitation.

[7]  L. Halstead,et al.  Metabolic and endocrine changes in spinal cord injury: I. The nervous system before and after transection of the spinal cord. , 1981, Archives of physical medicine and rehabilitation.

[8]  P. Bowen,et al.  Norms for nutritional assessment of American adults by upper arm anthropometry. , 1981, The American journal of clinical nutrition.

[9]  M. Rennie,et al.  Nitrogen estimation in biological samples by use of chemiluminescence. , 1980, Clinical chemistry.

[10]  J. Claus-Walker,et al.  Free amino acid excretion in tetraplegic patients , 1980, Paraplegia.

[11]  H. Kehlet,et al.  Role of neurogenic stimuli in mediating the endocrine-metabolic response to surgery. , 1980, JPEN. Journal of parenteral and enteral nutrition.

[12]  H. Munro,et al.  Urinary excretion of N gamma-methylihistidine (3-methylihistidine): a tool to study metabolic responses in relation to nutrient and hormonal status in health and disease of man. , 1978, The American journal of clinical nutrition.

[13]  R. Uauy,et al.  Muscle protein breakdown rates in humans based on Nτ-methylhistidine (3-methylhistidine) content of mixed proteins in skeletal muscle and urinary output of Nτ-methylhistidine☆ , 1978 .

[14]  D. Calloway,et al.  Sweat and miscellaneous nitrogen losses in human balance studies. , 1971, The Journal of nutrition.

[15]  D O Hancock,et al.  The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia , 1969, Paraplegia.

[16]  J. B. Weir.  New methods for calculating metabolic rate with special reference to protein metabolism , 1949, The Journal of physiology.

[17]  L. Eriksen,et al.  The ether soluble porphyrins found in the urine of normal man and rabbit. , 1962, Scandinavian journal of clinical and laboratory investigation.

[18]  G. D. Whedon,et al.  Effects of immobilization upon various metabolic and physiologic functions of normal men. , 1948, The American journal of medicine.