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Trauma Nutrition — Choosing Nutrition Mode — Clinical Pathway: ICU

Trauma Nutrition Clinical Pathway — ICU

Choosing Nutrition Mode

  • Initiate enteral nutrition if not contraindicated as soon as resuscitation is complete and hemodynamically stable
  • Initiate parenteral nutrition if enteral nutrition is contraindicated due to a dysfunctional GI tract
  • Transition between enteral and parenteral is expected
Feeding Method Diagnosis Considerations
Enteral-gastric
  • Moderate traumatic brain injury (TBI)
  • Long bone polytrauma
  • Complex mandibular fractures
  • Significant burns
  • Inhalation injury
  • Non-accidental trauma/neglect
  • Severe spinal cord injury (SCI)
Enteral-jejunal
  • Isolated severe closed head injury/TBI
  • Duodenal hematoma
  • Isolated pancreatic injury < grade 4
Parenteral
  • Bowel loss or multiple injuries to the gut
  • Open abdomen
  • High grade pancreatic injury
  • Massive intraperitoneal hemorrhage
  • Duodenal injury
  • Prolonged ileus
  • Massive transfusion protocol in use
  • Ongoing unresolved shock
  • Some complex pelvic fractures

 

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