Acta Ortopédica Mexicana

Dufoo JM, Cruz OA, Dufoo-Olvera M, García LO, López PJ, Aburto TA, Carranco TG, Rosa EE, Ibarra ZA, Vásquez OE
Metabolic changes and nutritional status in the spinal cord injured patient ASIA A. Evaluation and monitoring with routine laboratories, a feasible option
Acta Ortop Mex 2007; 21 (6)

Language: Español
References: 20
Page: 313-317
PDF: 118.21 Kb.

[Fulltext - PDF]

ABSTRACT

Introduction: Spinal Cord Injury ASIA A (tetraplegia) is a frequent pathology that may affect population regardless of age, sex or race, and that can induce metabolic abnormalities that may worsen the nutritional status of these patients. There are no existing specific protocols to treat these disorders in the specialized units in Mexico. Material and methods: We analyzed 16 patients at the Spine Clinic SS-DF, 18 years or older without any drug treatment or any previous disease, known or diagnosed when admitted to the hospital. Laboratory samples were obtained as well as the nutritional status was calculated at their admittance and discharge. Individually calculated nutritional support was administered starting at their third day of hospital stay. Results: 100% of the patients showed some type of metabolic disorder associated to the neurological injury. 50% of the patients were classified with severe malnutrition, 25% moderate and 25% mild, all improved at their discharge. Conclusions: We confirmed the presence of metabolic changes in these patients, the efficacy of routine laboratory in the Spine Clinic SS-DF for their evaluation, and that adequate nutritional support may help correct metabolic disorders in this patients.


Key words: metabolism, nutrition, cervical vertebrae, neck, quadriplegia, evaluation.


REFERENCES

  1. American Spinal Injury Association. International Standards for Neurological Classification of SCI 2002.

  2. Rodriguez DJ, Benzel EC, Clevenger FW: The metabolic response to spinal cord injury. Spinal Cord 1997; 35: 599-604.

  3. Dufoo OM, López PJ, García LO, y cols: Tratamiento quirúrgico de lesiones tumorales en la columna vertebral. Experiencia y propuesta para tratamiento temprano del segmento afectado. Rev Mex Ortop Traum 1998; 12(6): 558-63.

  4. Karlsson AK: Insulin resistance and sympathetic function in high spinal cord injury. Spinal Cord 1999; 37: 494-500.

  5. Bauman WA, Adkins RH, Spungen AM, et al: Is immobilization associated with an abnormal lipoprotein profile? Observations from a diverse cohort. Spinal Cord 1999; 37: 485-93.

  6. Kahn NN, Bauman WA, Sinha AK: Demonstration of a novel circulating anti-prostacyclin receptor antibody. Proc Natl Acad Sci USA Medical Sciences 1997; 94: 8779-82.

  7. Lynch AC, Palmer C, Anthony A, Roake JA, et al: Nutritional and immune status following spinal cord injury: a case controlled study. Spinal Cord 2002; 40: 627-30.

  8. Long CL, Schaffel N, Geiger JW et al: Metabolic response to injury and illness: estimation of energy and protein needs from indirect calorimetry and nitrogen balance. JPEN 1979; 3: 452-6.

  9. Mann S, Westenskow DR, Houtchens BA: Measured and predicted caloric expenditure in the acutely ill. Crit Care Med 1985; 13(3): 173-7.

  10. Barboriak JJ, Rooney CB, El Ghatit AZ, et al: Nutrition in spinal cord injury patients. J Am Paraplegia Soc 1983; 6(2): 32-6.

  11. Blissitt PA: Nutrition in acute spinal cord injury. Crit Care Nurs Clin North Am 1990; 2(3): 375-84.

  12. Jones LM, Legge M, Goulding A: Factor analysis of the metabolic syndrome in spinal cord-injuried men. Metabolism 2004; 53(10): 1372-7.

  13. Kaufman HH, Rowlands BJ, Stein DK, et al: General metabolism in patients with acute paraplegia and quadriplegia. Neurosurgery 1985; 16(3): 309-513.

  14. Kearns PJ, Thompson JD, Werner PC, et al: Nutritional and metabolic response to acute spinal-cord injury. JPEN J Parenter Enteral Nutr 1992; 16(1): 11-5.

  15. Laven GT, Huang CT, DeVivo MJ, et al: Nutritional status during the acute stage of spinal cord injury. Arch Phys Med Rehabil 1989; 70(4): 277-82.

  16. Rodríguez DJ, Clevenger FW, Osler TM, et al: Obligatory negative nitrogen balance following spinal cord injury. JPEN J Parenter Enteral Nutr 1991; 15(3): 319-22.

  17. MacDonald A, Hildebrandt L: Comparison of formulaic equations to determine energy expenditure in the critically ill patient. Nutrition 2003; 19(3): 233-9.

  18. Coleman WP, Benzel D, Cahill, et al: A critical appraisal of the reporting of the National Acute Spinal Injury Studies (II and III) of methylprednisolone in acute spinal injury. J Spinal Disord 2000; 13(3): 185-99.

  19. Dufoo OM, García LO, López PJ, y cols: Historia clínica secuencial para la evaluación de pacientes con lesión raquimedular. Descripción, análisis y experiencia de 14 años. Rev Mex Ortop Traum 1998; 12(6): 483-90.

  20. [Sin Autor] Nutritional support after spinal cord injury. Review. Neurosurgery 2002; 50(3 Suppl): S81-S84.