TREATMENT OF THE HYPERMETABOLIC RESPONSE TO CNS INJURY

这项研究的目的是改善神经病学的结果 通过为创伤的恢复提供最佳的系统环境 脑部受伤。神经损伤会导致全身异常，可能 对神经恢复有不利影响。高新陈代谢可以 迅速导致蛋白质-卡路里营养不良，导致 免疫功能不全、多器官衰竭和皮肤愈合延迟 受伤。由于全身应激反应，高血糖可能会恶化。 受伤脑组织乳酸酸中毒的严重程度。 拟议项目的第一个具体目标是开发一种方法 为神经损伤患者提供满足脑部的营养 和系统性蛋白质和能量需求，而不产生 高血糖症。一项临床试验将评估三醋酸甘油酯和 1，3-丁二醇作为颅脑损伤患者的非蛋白质热源。 喂养对大脑和全身新陈代谢的影响 被评估。 第二个具体目标是确定这些新陈代谢和 生理疗法将提高重型颅脑损伤后的死亡率。 第三个特定的目标是研究系统与 高代谢到中枢神经系统炎症反应的神经损伤。 这些研究将与临床试验一起进行 中描述的抗炎药氯喹和秋水仙碱 详细信息见项目4。

The objective of this research is to improve outcome from a nuerological injury by providing the optimal systemic environment for recovery of the injured brain. Neurological injury causes systemic abnormalities that may have adverse effects on neurological recovery. Hypermetabolism can rapidly result in protein-calorie malnutrition, causing immunoincompetence, multi-organ failure, and delayed healing of the injury. Hyperglycemia, due to the systemic stress response, may worsen the severity of lactic acidosis of the injured brain. The first specific aim of the proposed project is to develop a method of alimenting neurologically injured patients which will satisfy cerebral and systemic protein and energy requirements without producing hyperglycemia. A clinical trial will evaluate the use of triacetin and 1,3-butanediol as nonprotein caloric sources in head injured patients. The effects of the feedings on both cerebral and systemic metabolism will be evaluated. The second specific aim is to determine if these metabolic and physiological therapies will improve mortality after severe head injury. The tird specific aim is to study the relationship of the systemic hypermetabolism to the CNS inflammatory response to neurological injury. These studies will be performed in association with a clinical trial of the anti-inflammatory drugs, chloroquine and colchicine, as described in detail in Project 4.