Skip to main content

Part of the book series: Update in Intensive Care Medicine ((UICMSOFT,volume 34))

Abstract

Over the past 25 years, clinical studies have provided convincing evidence that early nutritional support benefits stressed surgical patients by preventing acute protein malnutrition [13]. Additionally, enteral nutrition, when compared to parenteral [46], has been demonstrated to be the preferred route of substrate delivery. Moreover, recent basic and clinical investigation offers the prospect that the benefits of traditional nutrition support can be amplified by supplementing specific nutrients that impart pharmacological immune-enhancing effects [722]. The focus of this chapter is to define optimal nutrition following major torso trauma and to describe a systematic method to deliver nutrition care in the ICU.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alexander JW, Macmillian BG, Stinnett JD, et al: Beneficial effects of aggressive protein feeding in severely burned children. Ann Surg 1980; 192 (4):505–517

    Article  PubMed  CAS  Google Scholar 

  2. Moore EE, Jones TN: Benefits of immediate jejunal feeding after major abdominal trauma - a prospective randomized study. J Trauma 1986; 26:874–883

    Article  PubMed  CAS  Google Scholar 

  3. Cerra FB: Hypermetabolism, organ failure, and metabolic support. Surgery 1987;101 (1):1–11

    Google Scholar 

  4. Moore FA, Moore EE, Jones, TN, McCroskey, BL, Peterson VM: TEN versus TPN following major abdominal trauma - reduced septic morbidity. J Trauma 1989; 29 (7):916–922

    Article  PubMed  CAS  Google Scholar 

  5. Kudsk KA, Croce MA, Fabian TC, et al: Enteral versus parenteral feeding: Effects on septic morbidity following blunt and penetrating abdominal trauma. Ann Surg 1992; 215 (5):503–511

    Article  PubMed  CAS  Google Scholar 

  6. Moore FA, Feliciano DV, Andrassy RJ, et al: Early enteral feeding, compared with parenteral, reduces postoperative septic complications - The results of a meta-analysis. Ann Surg 1992, 2169 (2):172–183

    Article  Google Scholar 

  7. Wilmore DW, Shabert, JK.: Role of glutamine in immunologic responses. Nutrition 1998;14 (7–8):7–8

    Article  PubMed  CAS  Google Scholar 

  8. Barbul A, Lazarou SA, Efron DT, Wasserbrug HL, Efrom G et al: Arginine enhances wound healing and lymphocyte immune responses in humans. Surgery 1990; 108 (2):331–336

    PubMed  CAS  Google Scholar 

  9. Alexander JW, Saito H, Trocki O, Ogle CK, et al: The importance of lipid type in the diet after burn injury. Ann Surg 1986; 204 (1):1–8

    Article  PubMed  CAS  Google Scholar 

  10. Van Buren CT, Kulkarni AD, Fanslow WC, Rudolph FBet al: Dietary nucleotides, a requirement for helper/inducer T lymphocytes. Transplantation 1985; 40 (6):694–697

    Article  PubMed  Google Scholar 

  11. Gottschlich MM, Jenkins M, Warden GD, et al: Differential effects of three enteral dietary regimens on selected outcome variables in burn patients. JPEN 1990;14 (3):225–236

    Article  CAS  Google Scholar 

  12. Cerra FB, Lehman S, Konstantinides N, et al: Improvement in immune function in ICU patients by enteral nutrition supplemented with arginine, RNA and menhaden oil is independent of nitrogen balance. Nutrition 1991; 7 (3):193–199

    PubMed  CAS  Google Scholar 

  13. Daly JM, Liberman MD, Goldfine J, et al: Enteral nutrition with supplemental arginine, RNA and omega-3 fatty acids in patients after operation: Immunologic, metabolic and clinical outcome. Surgery 1992;112 (1):56–67

    PubMed  CAS  Google Scholar 

  14. Brown RO, Hunt H, Mowatt-Larssen CA, Wojtysiak SL, Henningfield MF, Kudsk KA Comparison of specialized and standard enteral formulas in trauma patients. Pharmacotherapy 1994; 14 (3):314–320

    PubMed  CAS  Google Scholar 

  15. Moore FA, Moore EE, Kudsk KA, et al.: Clinical benefits of an immune-enhancing diet for early postinjury enteral feeding. J Trauma 1994; 37 (4):607–615

    Article  PubMed  CAS  Google Scholar 

  16. Bower RH, Cerra FB, Bershadsky B, et al: Early enteral administration of a formula supplemented with arginine, nucleotides, and fish oil in intensive care unit patients: Results of a multicenter, prospective, randomized clinical trial. Crit Care Med 1995; 23 (3):436–449

    Article  PubMed  CAS  Google Scholar 

  17. Daly JM, Weintraub FN, Shou J, Rosato EF, Lucia M: Enteral nutrition during multimodality therapy in upper gastrointestinal cancer patients. Ann Surg 1995; 221 (4):327–338

    Article  PubMed  CAS  Google Scholar 

  18. Kudsk KA, Minard G, Croce MA, et al: A randomized trial of isonitrogenous enteral diets following severe trauma: An immune-enhancing diet reduces septic complications. Ann Surg 1996; 224 (4):531–540

    Article  PubMed  CAS  Google Scholar 

  19. Senkal M, Mumme A, Eickhoff U, et al: Early postoperative enteral immunonutrition: Clinical outcome and cost-comparison analysis in surgical patients. Crit Care Med 1997;25 (9)1489–1496

    Article  PubMed  Google Scholar 

  20. Braga M, Gianotti L, Vignali A, Gestari A, Bisagni P, Carlo Vet al: Artificial nutrition after major abdominal surgery: Impact of route of administration and composition of the diet. Crit Care Med 1998;26:24–30

    Article  PubMed  CAS  Google Scholar 

  21. Atkinson S, Sieffert E, Bihari D: A prospective, randomized, double-blind, controlled clinical trial of enteral immunonutrition in the critically ill. Crit Care Med 1998; 26 (7):1164–1172

    Article  PubMed  CAS  Google Scholar 

  22. Weimann A, Bastian, L, Bischoff WE: Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma. Nutrition 1998;14 (2):165–72

    Article  PubMed  CAS  Google Scholar 

  23. Fry DE, Pearlstein L, Fulton RL, Polk HC: Multiple system organ failure: The role of uncontrolled infection. Arch Surg 1980; 115 (2):136–140

    Article  PubMed  CAS  Google Scholar 

  24. McArdle AH, Palmason C, Morency I, Brown RA: A rationale for enteral feeding as the preferable route for hyperalimentation. Surgery 1981; 90:616–623

    PubMed  CAS  Google Scholar 

  25. Mochizuki H, Trocki O, Dominioni L, Brackett KA, Joffe SN, Alexander JW: Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding. Ann Surg 1984; 200: 297–310

    Article  PubMed  CAS  Google Scholar 

  26. Kudsk KA, Carpenter G, Peterson SR, Sheldon GF: Effect of enteral and parenteral feeding in malnourished rats with hemoglobin - E. coil, adjuvant peritonitis. J Surg Res 1981;31 (2):105–110

    CAS  Google Scholar 

  27. Alverdy J, Chi HS, Sheldon GF: The effect of parenteral nutrition on gastrointestinal immunity: The importance of enteral stimulation. Ann Surg 1985; 202 (6):681–684

    Article  PubMed  CAS  Google Scholar 

  28. Lowry SF: The route of feeding influences injury responses. J Trauma 1990; 30 (12 Suppl):S10–15

    PubMed  CAS  Google Scholar 

  29. Kudsk KA, Li J, Renegar KB: Loss of upper respiratory tract immunity with parenteral feeding. Ann Surg 1996; 223 (6):629–35

    Article  PubMed  CAS  Google Scholar 

  30. Veterans Affair Total Parenteral Cooperative Study Group: Perioperative total parenteral nutrition in surgical patients. N Engl J Med 1991;325 (8):525–532

    Article  Google Scholar 

  31. Sandstrom R, Drott C, Hyltander A, et al: The effect of postoperative intravenous feeding (TPN) on outcome following major surgery evaluated in a randomized study. Ann Surg 1993; 217 (2):185–195

    Article  PubMed  CAS  Google Scholar 

  32. Brennan MF, Pisters PWT, Posner M, Quesada O, Shike M: A prospective randomized trial of total parenteral nutrition after major pancreatic resection for malignancy. Ann Surg 1994; 220 (4):436–441

    Article  PubMed  CAS  Google Scholar 

  33. Bell SJ, Mascioli EA, Bistrian BR, Babayan VK, Blackburn GL: Alternative lipid sources for enteral and parenteral nutrition: long and medium-chain triglycerides, structured triglycerides, and fish oils. J Am Diet Assoc 1991 91 (1):74–8

    PubMed  CAS  Google Scholar 

  34. Mendez C, Jurkovich GJ, Garcia I, Davis D, Parker A, Maier RV: Effects of an immune-enhancing diet in critically injured patients. J Trauma 1997;42 (5):933–940

    Article  PubMed  CAS  Google Scholar 

  35. Saffle JR, Wiebke G, Jennings K, Morris SE, Barton RG: Randomized trial of immune-enhancing enteral nutrition in burn patients. J Trauma 1997;42:793–800

    Article  PubMed  CAS  Google Scholar 

  36. Clemmer TP, Spuhler VJ.: Developing and gaining acceptance for patient care protocols. New Horizons 1998; 6 (1):12–19

    PubMed  CAS  Google Scholar 

  37. Marvin RG, McKinley BA, McQuiggan MM, Cocanour CS, Moore FA: Nonocclusive bowel necrosis in critically ill trauma patients receiving enteral nutrition manifests no reliable clinical signs for early detection. Am J Surg (in press)

    Google Scholar 

  38. Dudrick SJ, Latifi R, Fosnocht DE: Management of the short bowel syndrome. Surg Clin No Am 71 (3):625–43

    Google Scholar 

  39. ASPEN (1993) Guidelines for the use of parenteral and enteral nutrition in adult patients. JPEN 17 (4 Supp):1SA–26SA

    Article  Google Scholar 

  40. Heyman MB: General and specialized parenteral amino acid formulations for nutrition support. J Am Diet Assoc 1990;90 (3):401–8:401–8

    PubMed  CAS  Google Scholar 

  41. Heyland DK, Tougas G, King D, Cook DJ: Impaired gastric emptying in mechanically ventilated, critically ill patients. Intensive Care Med 1996;22 (12):1339–44

    Article  PubMed  CAS  Google Scholar 

  42. Myers JG, Page, CP, Steward, RM, Schwesinger WH, Sirinek KR, Aust JB:Complications of needle catheter jejunostomy in 2,022 consecutive applications. Amer J Surg 1995;170 (6):547–550

    Article  PubMed  CAS  Google Scholar 

  43. Coates NE, MacFadyen BV: Endoscopic jejunal access for enteral feeding. Am J Surg 1995; 169 (6):627–628

    Article  PubMed  CAS  Google Scholar 

  44. Reed RL, Eachempati SR, Russell MK, Fahkry C: Endoscopic placement of jejunal feeding catheters in critically ill patients by a push technique. J Trauma 1998;45 (2):388–393

    Article  PubMed  Google Scholar 

  45. Marvin RG, Moore FA, Cocanour CS, et al: Implementation of a procedure team improves utilization and reduces cost for critically ill patients in the ICU. J Trauma 1998; 44:425

    Article  Google Scholar 

  46. Duh QY, Way LW: Laparoscopic jejunostomy using T-fasteners as retractors and anchors. Arch Surg 1993; 128 (1):105–108

    Article  PubMed  CAS  Google Scholar 

  47. Morris AH: Algorithm based decision making. Principles and Practice of Intensive Care Monitoring. Tobin MJ (Ed). New York, McGraw-Hil1,l997:1355–1381

    Google Scholar 

  48. East TD, Morris AH, Wallace CJ, et al: A strategy for development of computerized critical care decision support systems. Int J Clin Mon it Comput 1992;8 (4):263–269

    Article  CAS  Google Scholar 

  49. Morris AH: Protocol management of adult respiratory distress syndrome. New Horizons 1993; 1 (4):593–602

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

McQuiggan, M.M., Moore, F.A. (2002). Nutrition Support in Blunt and Penetrating Torso Trauma. In: Pichard, C., Kudsk, K.A. (eds) From Nutrition Support to Pharmacologic Nutrition in the ICU. Update in Intensive Care Medicine, vol 34. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57119-0_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-57119-0_20

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-42604-2

  • Online ISBN: 978-3-642-57119-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics