Spinal Cord Injury

SCI: Caloric and Protein Needs (2003)

• Assessment
  What are the caloric needs during the acute and rehabilitation phases following spinal cord injury? (2003)

  • Conclusion

    Caloric needs of spinal cord injured patients during the acute and rehabilitation phases should be based on measured energy expenditure (serial indirect calorimetry measurements).  If indirect calorimetry is not available, needs can be estimated using 22.7 kcal/kg body weight for individuals with quadriplegia and 27.9 kcal/kg for those with paraplegia.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Caloric Needs in Spinal Cord Injury Patients (2003)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Chin DE, Kearns P. Nutrition in the Spinal-Injured Patient. NCP. 1991; 6(6):213-222. 
      • Cox SAR, Weiss SM, Posuniak EA, Worthington P, Prioleau M, Heffley G. Energy Expenditure after Spinal Cord Injury: Evaluation of Stable Rehabilitating Patients. J Trauma 1985; 25: 419-423.
      • Houda B. Evaluation of Nutritional Status in Persons with Spinal Cord Injury: A Prerequisite for Successful Rehabilitation. SCI Nursing 1993;10(7):4-7.
      • Kearns PJ, Thompson JD, Werner PC, Pipp TL, Wilmot CB. Nutritional and Metabolic Response to Acute Spinal Cord Injury. J Parenter Enteral Nutr, 1992; 16(1): 11-15.
      • Laven GT, Huang CT, DeVivo MJ, Stover SL, Kuhlemeier KV, Fine PR. Nutrition Status During the Acute Stage of Spinal Cord Injury. Arch Phys Med Rehabil 1989; 70: 277-282.
      • Rodriguez DJ, Benzel EC, Clevenger FW. The Metabolic Response to Spinal Cord Injury. Spinal Cord, 1997; 35: 599-604.
• Intervention
  What are the protein needs during the acute and rehabilitation phases following spinal cord injury? (2003)

  • Conclusion

    Protein intakes of 0.8 to 2.4 grams/kg have been used without untoward effects in the acute phase of SCI. A level of 2 gm/kg is a prudent guideline for estimating protein and nitrogen needs during this phase.

  • Evidence Summary: Protein needs of Spinal Cord Injury Patients
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Blissitt PA. Nutrition in Acute Spinal Cord Injury. Critical Care Nursing Clinics of North America. 1990;2(3):375-384.
      • Rodriguez DJ, Benzel EC, Clevenger FW. The Metabolic Response to Spinal Cord Injury. Spinal Cord, 1997; 35: 599-604.
      • Rodriguez DJ, Clevenger FW, Osler TM, Demarest GB, Fry DE. Obligatory Negative Nitrogen Balance Following Spinal Cord Injury. J Parenter Enteral Nutr 1991; 15(3): 319-322.