Nutritional Support in Polytrauma Patients with Organ Dysfunction

Abstract

A significant number of deaths in polytrauma occurs days to weeks after the primary insult, caused by infection and organ failure and their resultant hypercatabolic state, causing acute protein malnutrition. Nutrition therapy should be planned and integrated with other measures of management for patients with polytrauma and major burns. The goals of nutrition therapy in these patients include early delivery of nutritional components (energy, protein, fluid and micronutrients), by enteral, parenteral or both routes, to prevent protein energy wasting (PEW), preserve lean body mass (LBM), to promote wound healing. However, resuscitation efforts should precede nutritional support. Critically ill polytrauma patients with their proinflammatory states and increased oxygen free radicals production will benefit from immunonutrion. Immunonutrients include glutamine, arginie, ω-3 fatty acids, Selenium and some vitamins. They are substrates which modulate inflammatory process in order to decrease critical illness severity and avoid complications. Key words: Polytrauma, critically ill patients, systemic inflammatory response syndrome (SIRS), multiorgan failure (MOF), enteral nutrition (EN), parentral nutrition (PN), immunonutrition, protein energy wasting (PEW).