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Diaeta
On-line version ISSN 1852-7337
Abstract
JEREB, Silvia and AADYND. Grupo de Estudio Nutrición y Neurociencias. Subgrupo Neurocrítico et al. Impact of sedation on the energy expenditure of neurocritical patients. Diaeta [online]. 2017, vol.35, n.158, pp.38-43. ISSN 1852-7337.
Sedoanalgesia in the neurocritical patient allows reduction of pain, control of body temperature, favors adaptation to mechanical ventilation and prevents the increase of intracranial pressure. In addition, it decreases brain activity by reducing oxygen consumption and heart rate, directly impacting upon energy expenditure at rest. A literature review was carried out with the objective of updating and describing the effect of sedation on the energy expenditure of critically ill patients with cerebral injury, for which 4 electronic databases were consulted: MEDLINE, EMBASE, LILACS, Cochrane, from 2006 to 2016. It was observed that the energy expenditure in the neurocritical patient is highly variable due to the use of sedoanalgesia, muscle relaxants and barbiturates that reduce it by 12 to 32%, being lower the decreases with the use of propranolol or morphine, attenuating the hypermetabolism characteristic of these patients. In conclusion, the use of sedation should be taken into account when estimating the energy requirements in order to avoid the adverse consequences derived from hypo and hyperalimentation, and it is necessary to carry out more studies in this respect.
Keywords : Sedation; Energy expenditure; Traumatic brain injury; Subarachnoid hemorrhage; Intracranial hypertension.