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 |