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Current Surgery Reports

, 6:15 | Cite as

Update on Feeding the Open Abdomen in the Trauma Patient

  • Katie Love BowerEmail author
  • Bryan R. Collier
Trauma Surgery (J. Diaz, Section Editor)
  • 46 Downloads
Part of the following topical collections:
  1. Trauma Surgery

Abstract

Purpose of Review

Describe how and when nutrition for trauma patients should be provided after damage control laparotomy.

Recent Findings

Early enteral nutrition is a requisite component of open abdomen critical care support to achieve optimal outcomes. Providing trophic enteral nutrition is beneficial. Enteral nutrition with an open abdomen complicated by enteroatmospheric fistula is safe and feasible.

Summary

Enteral nutrition is initiated with resolution of acidosis, coagulopathy, and hypothermia. Absent intestinal discontinuity, the only absolute contraindication, enteral nutrition is started as soon as possible via any standard route of enteral access. Post-pyloric access should be trialed in patients intolerant to gastric feeds. Parenteral nutrition is considered if an absolute contraindication to enteral nutrition is expected to persist beyond 5–7 days, the patient is intolerant to enteral nutrition, or caloric goal is not achieved with enteral nutrition after 5–7 days. Protein requirements for the OA patient are higher, 2 g/Kg/day.

Keywords

Trauma Nutrition Enteral nutrition(EN) Parenteral nutrition(PN) Open abdomen(OA) Damage control Malnutrition Critical illness 

Notes

Compliance with Ethical Guidelines

Conflicts of interest

Katie Love Bower and Bryan R. Collier declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, Section of Trauma and Surgical Critical CareVirginia Tech Carilion School of Medicine and Carilion ClinicRoanokeUSA

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