Resting Energy Needs in Brain Dead Patients (reSting EneRgy nEeds iN brAin DEad Patients)

Study Overview
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Brief Summary
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The study will examine the resting energy need (REE) in patients suffering from brain damage. For the measurement of REE will be used a metabolic computer (which with continuous recording of breath-to-breath volume (Vt), respiratory rate (RR) of ventilation per minute volume (MV) ), of inhaled and exhaled gases (O2 and CO2) has the ability to calculate the values of VO2, VCO2 and with the help of equations the values of REE and RQ.

Detailed Description
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This is a retrospective observational study concerning patients suffering from brain damage. All the patients suffering from brain damage are monitored in order to examine their resting energy needs (REE). For the measurement of REE the metabolic computer (Medical Graphics, Ultima CCM, Minneapolis, USA) is used. The main purpose of this study is to reveal the (REE) changing in patients with brain death semiology and examine if the REE changes could be related to the outcome of a patient with intracranial pathology. Moreover the study will examine if the changes in REE measurement are related to changes in flow velocities in the midbrain. Any measurement shall be preceded by calibration of the metabolic computer pneumotachograph with a 3-liter syringe with an acceptable error of less than 9 ml / lit. The metabolic unit is calibrated for VO2 measurements with two calibration cylinders containing 21% and 12% O2 and for VCO2 measurements with calibration gases containing 5% and 0% CO2 respectively. The measurement of flow velocities in the middle cerebral artery will be done with the transcranial Doppler using a low frequency (2 MHz) ultrasound head After their final diagnosis (brain death or not) the patients' characteristics will be compared according to the categorization as brain dead or not.

Official Title
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Resting Energy Needs in Brain Dead Patients

Conditions
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Brain Injuries, Brain Edema, Brain Hemorrhage, Brain Death

Intervention / Treatment
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* Diagnostic Test: REE - Resting Energy Expenditure
* Diagnostic Test: Transcranial Doppler


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients entering the ICU Age 18-90 years old Clinical Diagnosis of brain damage GCS <=8 Exclusion Criteria: Patients <18 years old and >90 years old, Past history CNS disease (alzheimer's disease, multiple sclerosis, brain tumor, aneurysm) in the last 3 years Past history of cachexia due to cancer

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with brain damage<br>ICU patients with brain damage (due to cardiac arrest, intracranial hemorrhage or traumatic brain injury). and GCS upon entry <=8. All patients will be examined with a transcranial doppler (TCD) and a metabolic computer (for the measurements of REE) After the final diagnosis the patients' characteristics will be compared according to if they were brain dead or not | Diagnostic Test: REE - Resting Energy Expenditure<br>* REEs represent 60-70% of the needs for a sedentary person and 50% of physically active people. For the measurement of REE will be used the metabolic computer (Medical Graphics, Ultima CCM, Minneapolis, USA), which with continuous recording of breath-to-breath volume (Vt), respiratory rate (RR) of ventilation per minute volume (MV) ), of inhaled and exhaled gases (O2 and CO2) has the ability to calculate the values of VO2, VCO2 and with the help of equations the values of REE and RQ. All patients in the study will be monitored with the metabolic computer. Their measurements will be recorded every day during their stay in the ICU.<br>Diagnostic Test: Transcranial Doppler<br>* The measurement of flow velocities in the middle cerebral artery will be done with the transcranial Doppler using a low frequency (2 MHz) ultrasound head. All patients entering the study will be examined with the TCD every day during their stay in the ICU.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| REE changes | Changes in REE in patients with brain damage | Day 0 (upon entry to ICU) up to 30 days | 
| MCA changes | Changes in flow rates in Median Cerebral Artery (MCA) in patients with brain damage | Day 0 (upon entry to ICU) up to 30 days | 
| REE and MCA correlation | Correlate the REE changes with those in flow rates in MCA | Day 0 (upon entry to ICU) up to 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prognostic value of REE | Compare the values of REE upon entry in the ICU in patients with final diagnosis as brain dead or not | Day 0 (upon entry to ICU) up to 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Resting energy expenditure (REE), Brain Death, Brain injuries