[Principles and practice of nutrition following trauma]

Abstract

Nutrition should form part of intensive care for all polytrauma patients to prevent catabolic breakdown of body proteins. Enteral (tube) feeding is preferable whenever normal gastrointestinal function is confirmed. Parenteral nutrition is best tolerated via an adapted "all-in-one" solution. Due to the catabolic trauma reaction, a high protein content of 1.5-2 g/kg body weight/day and a calorie-nitrogen ratio of 80-100:1 is recommended. Energy supply should be partly in the form of fat and carbohydrates, mainly glucose. Xylitol as sugar substitute can be added to prevent hyperglycemia in the event of trauma-related glucose intolerance.