Which of the following statement(s) is/are true concerning nutritional support of the injured patient?
A. The goal of nutritional support is maintenance of body cell mass and limitation of weight loss to less than 25% of preinjury weight B. Under-nutrition may compromise the patient’s available defense mechanisms C. Nutritional support is an immediate priority for the trauma patient D. Fifty percent of non-nitrogen caloric requirements should be provided in the form of fat
Under-nutrition may compromise the patient’s available defense mechanisms-metabolic response to injury results in increased energy expenditure. if energy intake is less than expenditure, oxidation of body fat stores and erosion of lean body mass will occur with resultant loss of weight. when weight loss exceeds 1015% of body weight, the complications of malnutrition interact with disease processes, with increased morbidity and mortality rates. the goal of nutritional support is maintenance of body cell mass and limitation of weight loss to less than 10% preinjury. the major impact of nutritional support in the trauma patient is to aid host defense. under-nutrition may compromise the available host defense mechanism and may thus increase the likelihood of invasive sepsis, multiple organ system failure, and death. resuscitation, oxygenation and arrest of hemorrhage are immediate priorities for survival. nutritional support is an essential part of the metabolic care of the critically ill patient and should be instituted after resuscitation before significant weight loss occurs. the nutritional requirements of a trauma patient can be determined by determining basal metabolic rate with appropriate increases based on extent of injury and hospital activity. after initial determination of nitrogen requirements, caloric requirements should be distributed at a ratio of 70% as glucose and 30% as fat.