Abstract | OBJECTIVE: Nutrition support in the severely injured trauma patient is crucial to minimize the hypermetabolic stress response. Even though enteral nutrition is the preferred method of feeding, it is not always feasible after multiple trauma. We present a complex nutritional case in a patient who sustained severe abdominal trauma with a severe liver injury, rib fractures, and pulmonary contusion. METHODS: RESULTS: On post- trauma day 27, bowel edema was significantly less, and a nasoenteric feeding tube was placed and enteral feeding initiated. By post- trauma day 31, full enteral feeds were tolerated, and total parenteral nutrition was stopped. Nutrient provision was adjusted daily to account for organ and metabolic changes including hepatic, pulmonary, and renal dysfunction. The patient did well and was eventually extubated and eating a regular diet. CONCLUSION: With careful monitoring and adjusting of the nutritional plan, a hypermetabolic complex trauma patient with an open abdomen can be fed optimally, safely, and successfully despite increased bowel edema and multiple organ dysfunction.
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Authors | Blake McKibbin, Gail Cresci, Michael Hawkins |
Journal | Nutrition (Burbank, Los Angeles County, Calif.)
(Nutrition)
Vol. 19
Issue 6
Pg. 563-6
(Jun 2003)
ISSN: 0899-9007 [Print] United States |
PMID | 12781863
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Abdominal Injuries
(complications, therapy)
- Acute Kidney Injury
(therapy)
- Adult
- Blood Coagulation Disorders
(complications, therapy)
- Critical Care
- Enteral Nutrition
- Erythrocyte Transfusion
- Humans
- Hypotension
(complications, drug therapy)
- Male
- Nutritional Support
- Parenteral Nutrition, Total
- Plasma
- Platelet Transfusion
- Pneumonia
(complications, therapy)
- Renal Dialysis
- Respiratory Distress Syndrome
(complications, therapy)
- Vasoconstrictor Agents
(therapeutic use)
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