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Trauma Nutrition — Optimal Nutrition Intervention — Clinical Pathway: ICU

Trauma Nutrition Clinical Pathway — ICU

Optimal Nutrition Interventions by Post-injury Day

Delays in initiating and advancing feeds, as well as interrupting feeds for procedures, contribute to inadequate calorie intake, weight loss, and compromised healing. Review the table below for guidance on optimal nutrition timeline.

Post-injury Day Interventions to Optimize Nutrition by Nutrition Mode
2
Gastric Order NG/OG and start trophic feeds
Jejunal Coordination with IR/OR for NJ placement (+/- bridle)
Parenteral Coordination with PICU/IR/OR for CVC placement
3
Gastric Advance feeds to reach patient-specific goal in 24-36 hrs
Jejunal Initiate trophic feeds
Parenteral Initiate PN
4
Gastric Feeds reach patient-specific goal
Jejunal Advance feeds to reach patient-specific goal in 24-36 hrs
Parenteral Advance PN
5
Gastric Patient-specific goal reached
Ensure delivery of 100% of ordered EN
Jejunal Patient-specific goal reached
Parenteral Advance PN
6 Nutrition at patient-specific goal
7 Full nutrition support, continue to monitor and optimize calories
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