Clinical Pathway for Management of Nutrition in the Traumatically Injured Patient Requiring ICU Care for ≥ 3 Days

  • Initiate nutrition within 72 hours, achieve calorie goal by post injury 7
  • Inadequate nutrition is associated with prolonged recovery time and increased morbidity and mortality

Post Injury Day


Plan, Execute Access


Begin Feeds


Optimal route if not contraindicated

  • Arrange for Appropriate Access for TPN
    • OR/PICU/IR to obtain central access as indicated
  • Review with Trauma Dietician
    • Discuss patient specific goals
    • Order TPN
    • Check TPN panel morning after starting TPN
    • Advance TPN to reach goal within 36 hrs





Nutrition at Patient Specific Goal

  • Monitor Nutrition during PICU Care
  • Biweekly weight checks (Monday/Thursday)
  • Weekly nutrition assessment competed by Trauma Dietitian
  • Daily discussion between PICU and Trauma teams re:
    • % of estimated nutrition needs received
    • Address barriers if receiving < 90% of goal
  • Daily reassessment of ability to start/advance enteral feeds in patients receiving TPN
Posted: September 2021
Authors: R. Cook, RD; J. Kloss, CRNP; T. Blinman, MD; G. Nace, MD; B. Bruins, MD; M. Campbell, RN;
E. Elliot, MD; S. Irving, CRNP