Metabolic Response to Hypertensive Intracerebral Hemorrhage and Ruptured Intracranial Aneurysm

Abstract

Oxygen consumption, carbon dioxide production, respiratory quotients, and resting metabolic expenditure were measured in 25 patients with hypertensive intracerebral hemorrhage or with ruptured intracranial aneurysm in their acute stage. Metabolic measurements were carried out with the indirect calorimetry technique on admission within 72 hours from the onset. At the same time, urine was collected for 24 hours to measure the urinary catecholamines excretion. The mean value of resting metabolic expenditure was 130.0% and this positively correlated with urinary catecholamines, especially noradrenalin excretion. Oxygen consumption and carbon dioxide production correlated also positively to urinary catecholamines excretion. Maximum value of resting metabolic expenditure was up to 186.0% of that expected for an uninjured resting person of the same age, sex, and body surface area. On the other hand, respiratory quotients did not have any significant correlation with oxygen consumption, carbon dioxide production, resting metabolic expenditure, or urinary catecholamines excretion. From these facts, it is implied that there is an overactivity of sympathetic nervous system in the acute stage of hemorrhagic cerebrovascular diseases, that the over-flow might directly influence oxygen consumption, carbon dioxide production, and resting metabolic expenditure, and that, moreover, the hypermetabolic state should be taken into consideration to manage patients with hemorrhagic cerebrovascular diseases, as malnutrition might cause weight loss and immune incompetence.