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Metabolism in the Trauma Patient

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Surgical Metabolism

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Abstract

Injured patients represent a unique population as they are hypermetabolic and thus require increased feeding to meet energy requirements. Numerous studies have documented that the early provision of enteral nutrition to critically injured patients is beneficial. However, trauma poses a number of unique and difficult nutritional challenges. Damage control surgery with bowel in discontinuity, open abdomens, recent bowel anastomosis, and the need for frequent operative interventions all make achieving nutritional adequacy difficult. With the increase in elderly trauma patients, adequate provision of nutrition to this high risk group is even more important, but studies suggest we are significantly underfeeding these patients. Additionally, sarcopenia, or low muscle mass, upon admission has been recognized as risk factor for mortality in the injured elderly and may be made worse by underfeeding and lack of mobilization. Techniques to assess muscle mass are discussed including the use of ultrasound.

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Authors and Affiliations

  1. Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe BLVD (OCL 112), Houston, TX, 77030, USA

    Stephanie Gordy MD, FACS

  2. Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA

    Rosemary A. Kozar MD, PhD

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Correspondence to Stephanie Gordy MD, FACS .

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  1. Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA

    Kimberly A. Davis

  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA

    Stanley H. Rosenbaum

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Gordy, S., Kozar, R.A. (2014). Metabolism in the Trauma Patient. In: Davis, K., Rosenbaum, S. (eds) Surgical Metabolism. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1121-9_5

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