• Karolina Krakau, Marianne Omne-Pontén, Torbjörn Karlsson, and Jörgen Borg.
• Centre for Clinical Research Dalarna, Dummy institution, Sweden. karolina.krakau@ds.se
• Brain Inj. 2006 Apr 1;20(4):345-67.

Primary ObjectiveTo examine the evidence on the metabolic state and nutritional treatment of patients with moderate-to-severe traumatic brain injury (TBI).Research DesignA systematic review of the literature.Methods And ProceduresFrom 1547 citations, 232 articles were identified and retrieved for text screening. Thirty-six studies fulfilled the criteria and 30 were accepted for data extraction.Main Outcomes And ResultsVariations in measurement methods and definitions of metabolic abnormalities hampered comparison of studies. However, consistent data demonstrated increased metabolic rate (96-160% of the predicted values), of hypercatabolism (-3 to -16 g N per day) and of upper gastrointestinal intolerance in the majority of the patients during the first 2 weeks after injury. Data also indicated a tendency towards less morbidity and mortality in early fed patients.ConclusionsThe impact of timing, content and ways of administration of nutritional support on neurological outcome after TBI remains to be demonstrated.

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