[Nutritional status and nutritional support of patients with chronic disorders of consciousness at the stage of medical rehabilitation].
M V NikiforovS S AleksaninA A KorolevPublished in: Voprosy pitaniia (2024)
Chronic disturbances of consciousness (CDC) are a consequence of severe brain damage and are conditions that arise after emerging from a coma with the preservation of the sleep-wake cycle in the absence of signs of conscious behavior. When conducting inpatient medical rehabilitation of this group of patients, the state of nutritional status is not always taken into account and, as a rule, there is no nutritional support with an assessment of metabolic needs, including the introduction of various modes of physical activity during physical therapy and an increase in physical load on the patient's body. The purpose of the study was to assess the nutritional status and optimize the nutritional support system in patients with CDC at the inpatient stage of medical rehabilitation (MR). Material and methods . The study analyzed the results of examination and treatment of 152 patients with CDC of traumatic origin who received medical rehabilitation from 2016 to 2022 in the Department of Physical and Rehabilitation Medicine of the Nikiforov Russian Center of Emergency and Radiation Medicine, Ministry of Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters. Results . In patients with CDC of traumatic genesis, signs of malnutrition (objective, anthropometric, laboratory) were diagnosed at the inpatient stage of MR, and there were also risks of malnutrition progression with the introduction of additional physical activity. Conclusion . To create an effective and adequate nutritional support system during inpatient MR, metabolic monitoring (indirect calorimetry) is of fundamental importance, taking into account the influence of additional physical activity. The use of a calculation method for estimating energy requirements can lead to hyperalimentation.
Keyphrases
- physical activity
- mental health
- healthcare
- palliative care
- cell cycle
- spinal cord injury
- body mass index
- end stage renal disease
- magnetic resonance
- chronic kidney disease
- emergency department
- acute care
- ejection fraction
- sleep quality
- public health
- oxidative stress
- risk assessment
- cell proliferation
- prognostic factors
- magnetic resonance imaging
- multiple sclerosis
- early onset
- radiation therapy
- computed tomography
- resting state
- brain injury
- subarachnoid hemorrhage
- patient reported
- smoking cessation