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OBJETIVO: Descrever a evolução clínica e nutricional de paciente queimado fasciotomizado com uso de terapia nutricional imunomoduladora. RELATO DO CASO: Estudo do tipo relato de caso, realizado durante 52 dias na Unidade de Tratamento de Queimados do Hospital da Restauração Governador Paulo Guerra, em Recife-PE. Paciente do sexo masculino, adulto, 27 anos, proveniente do interior de Pernambuco, sem comorbidades, queimado por eletricidade de alta voltagem após acidente de trabalho, evoluindo com síndrome compartimental do membro superior esquerdo e submetido a fasciotomia. Prescrita dieta por via oral associada à suplementação imunomoduladora de característica hipercalórica, hiperproteica, contendo arginina e alto teor de oligoelementos e micronutrientes. Durante o internamento, o paciente apresentou manutenção do estado nutricional, com adesão de novos hábitos alimentares que contribuíram para a cicatrização do membro afetado. CONCLUSÃO: A terapia nutricional imunomoduladora individualizada beneficiou a reparação tecidual, cicatrização e redução do risco de amputação em paciente queimado fasciotomizado.

OBJECTIVE: To describe the clinical and nutritional evolution of a burn patient submitted to fasciotomy and immunomodulating nutritional therapy. CASE REPORT: A case-report study was conducted over a 52-day period at the Burn Treatment Unit of Governador Paulo Guerra Restauração Hospital in the city of Recife, Brazil. A 27-year-old male patient, brown skin color, from the instate region of the state of Pernambuco, without comorbidities, suffered a high-voltage electrical burn after a work accident, developing compartment syndrome of the left upper limb, and was submitted to fasciotomy. An orally diet was prescribed associated with immunomodulatory supplementation with a hypercaloric, hyper protein character, with arginine and high content of trace elements and micronutrients. During hospitalization, the patient's nutritional status was maintained with the adherence to new dietary habits, which contributed to the healing of the affected limb. CONCLUSIONS: Individualized immunomodulating nutritional therapy benefits the tissue repair and healing processes, reducing the risk of amputation in burn patients submitted to fasciotomy.

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RESUMO

Cortical spreading depression (CSD) is a brain electrical response related to neural activity and probably also related to diseases like migraine and epilepsy. Adverse conditions like malnutrition and exposure to a warm environment early-in-life can permanently alter brain development, changing electrophysiological features of the brain responses and rendering the brain prone to febrile seizures. Here we investigated the lasting effects of heat exposure on brain CSD propagation in well-nourished and malnourished developing rats. From postnatal days 10-29, rats were exposed to daily sessions (one session per day, five sessions per week during 3 weeks; total of 15 sessions) of a warm environment (40+/-2 degrees C). At 30-40 days and 90-120 days of life (young and adult age-ranges, respectively), they were anesthetized (urethane+chloralose; 1000 + 40 mg/kg ip) and the electrocorticogram plus the slow potential change accompanying CSD were recorded on two parietal points for 4h. Compared to controls (maintained on the normal environment temperature, 23+/-2 degrees C), heat-exposed rats displayed higher CSD velocities of propagation (P<0.05; ANOVA plus Tukey test) at both age-ranges and nutritional statuses. The mean+/-S.D. CSD velocities (in mm/min) were: for control- and heat-exposed well-nourished rats, 3.75+/-0.15 and 4.17+/-0.19 (young groups), and 3.33+/-0.06 and 3.88+/-0.26 (adult); for the same control and heat exposure conditions in the malnourished rats, 4.30+/-0.22 and 5.31+/-0.46 (young), and 4.18+/-0.20 and 4.88+/-0.35 (adult). In contrast to early malnutrition, heat exposure did not affect body and brain weights. Data support the hypotheses that (1) early heat exposure long-lasting facilitates CSD propagation and (2) this effect is not modified by early malnutrition.

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