elite athelete with spinal cord injury

[gx2]

Hi , I require assitance with a young 48 year old male "elite
athelete" being transfered home from a Regional Center - 3 weeks post
spinal cord injury C3 ,C5 ,C7 after a bike accident.
He was at his optimum fitness state when injured 190 cm , 77 kg, BMI
was 21 (all lean).
He is returning today having lost 14.5 kg in 3 weeks with several
bedsores uncertain the stages (have no labs yet), likely 2nd
pneumonia , did not receive Glutamine (IV or enteral).
He has had some sensation with range of motion exercises ,
temperatures , and some very small triceps contractions .
Peg tube feeds were at a goal rate of 90 ml /hr Isosource VHN =2160
cal ,134 gm protein..
My questions are as follows
1) I believe his needs fall outside our standards to est calories and
perhaps protein given his usual metabolic rate (training elite
athelete ) even at 3 weeks post trauma? WE have no metabolic cart . I
would think a detailed diet hx would be the closest method of est his
needs with wts etc to follow? HELP!
2) Can he be placed on an oscillating bed?He still has a collar to
stabilize the fractures.( I think yes given he can have chest PT).
3)When does the trauma stress abate in spinal trauma. Would using C
reactive protein and prealbumin to assess when stress is abating
work?
Thank you for any assistance you can provide .

[Corilee Watters]

Sorry to hear about this patient.  SCIs are a very heterogenous population - difficult to determine initially what innervation is left, and thus what muscle function.  Attached is a review that summarizes various methods of energy requirements.

Corilee Watters, PhD, RD, CNSC
UH - phone: 808-956-7581.

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Dr. Corilee Watters, MSc, RD, PhD, CNSC
Asst. Professor Nutrition, University of Hawaii
Department of Human Nutrition, Food and Animal Science
1955 East-West Road, Agricultural Science 314 J,    Honolulu, HI  96822
ph: 808-956-7581  fax:  808-956-4024
e-mail: cwat...@hawaii.edu

[gx2]

Corilee , Thank you for sharing the article . I have reassessed his
needs using the article and am on the right track - nice to have some
reinforcement. Hope his rate of loss can be reduced .

On Sep 27, 2:10 pm, Corilee Watters <corileewatt...@gmail.com> wrote:
> Sorry to hear about this patient.  SCIs are a very heterogenous population -
> difficult to determine initially what innervation is left, and thus what
> muscle function.  Attached is a review that summarizes various methods of
> energy requirements.
>
> Corilee Watters, PhD, RD, CNSC
> UH - phone: 808-956-7581.
>

> e-mail: cwatt...@hawaii.edu
>
>  ASCI.pdf
> 92KViewDownload