CROSS TALK BETWEEN CEREBRAL ACTIVITY AND SYSTEMIC METHABOLISM

Background and aims During a severe brain accidents like massive haemorragic event or severe cerebral trauma, occur numerous byochemical and hormonal changes. The cerebral neuroendocrine storming,the imparired tissutal perfusion due to the vasoplegia,the reduction in oxygen Delivery,the Microcirculatory changes, involve in Mitochondrial dysfuction and reduction in systemic methabolism AIMS: Our aim is to evaluate the 'metabolic stupor' during the acute phase of cerebral severe events and put it into relation to the degree of GCS. METHODS: We conducted observational pilot study: 21 severe injured patients admitted in ICU were enrolled: 10 with severe brain damage and 11 With abdominal/ thoracic trauma, Calorimetric assessment, ISS and GCS evaluation were detected within the first 48 hours and after the 3rd day of admission RESULTS: Group A MEDIAN at the admission: gcs 5,4 , REE 1120, ISS > 50, age 56,8; 5M, 5F Group B median at the admission gcs 9,9, median ree 1700, ISS<50, age 49,8 , 6M, 4 F REE of all patients is lower in group A with severe brain injury than in the Group B with a severe abdominal injury. The REE values increase proportionally to the gcs value after the first 48-72 H CONCLUSION The lower the GCS is, the lower the basal metabolic rate.(Fig2) The basal methabolism followes prportionally the severity of cerebral damage Calorimetry evaluation seems to be foundamental to avoid over or under nutritional treatment. IC Gruppo A IC GRUPPO B 4 2 0 GCS REE Value FIG 1 REE value followes proportionally GCS FIG 2 IC in group A and B