脳卒中の栄養療法

抄録

In the nutrition therapy for stroke patient, it is important to carry out appropriate the nutritional management with understanding of the pathophysiology of each stroke types, cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage. In addition, the nutrition management according to the severity and stage in each patient should be performed.

In the acute stage of stroke, shorten the fasting period and start the enteral nutrition as soon as possible. In cases without dysphagia, oral intake should be started promptly, and in cases with severe dysphagia or with comatose, the nutritional management by tube feeding should be performed. In severely stroke cases, a hyperglycemia condition might be likely to occur, because the catabolism may be accelerated by the invasive stress. The energy dose and the nutritional composition must be set in consideration of glycemic variability.

On the other hand, the energy consumption would be increasing during recovery stage. The appropriate nutrition therapy should be practiced for the elderly patient coexisting with frailty or sarcopenia, who make up the majority of the hospitalization on the recovery rehabilitation floor.

The basic concept of nutrition therapy in stroke is the early initiation of enteral nutrition managed by an appropriate protocol. These practices may help improve outcomes in stroke patients.