Metabolic Response to Trauma and Nutritional Support Quiz

Metabolic Response to Trauma and Nutritional Support for Surgical Patients

• Metabolic response to trauma refers to the body's reaction to injury or impact, such as surgery, burn, or sepsis.
• The metabolic response consists of two phases: Ebb and Flow. In the Ebb phase, the body tries to decrease energy consumption, characterized by an increase in pulse rate, respiratory rate, cardiac output, and hyperthermia.
• The Flow phase consists of two sub-phases: Catabolic and Anabolic. The Catabolic phase is characterized by a decrease in cardiac output, hypotension, weak pulse, decrease in O2 consumption, and hypothermia.
• The body needs glucose for energy, which is obtained through glycogenolysis and gluconeogenesis in the liver. Cortisol, aldosterone, and ADH hormones help provide glucose and increase Na and water retention.
• The body has three energy sources: glycogen in the liver, body fat, and protein in skeletal muscle.
• In case of prolonged trauma or starvation, the body starts cannibalizing itself, leading to a decrease in body weight, body fat, skeletal muscle wasting, and an increase in glucose in the blood.
• Nutritional therapy can be given orally, enterally (through the gastrointestinal route), or parenterally (through the venous system) to prevent or treat malnutrition.
• Malnourished patients make poor surgical candidates, and surgery causes a stress response that leads to hypermetabolic or catabolic response. Malnutrition increases the risk of post-operative complications.
• Nutritional methods include oral nutritional supplements, nasogastric tube feeding, gastrostomy feeding, jejunal feeding, and parenteral nutrition.
• Rapid recovery after surgery requires a decrease in Nil By Mouth time before surgery, carbohydrate loading before surgery, minimal surgery, rapid feeding after surgery, and early mobilization.
• Diagnostic points for malnutrition include BMI < 20 kg/m2, weight loss > 10% of body weight over the last 3 months, and albumin serum level < 30gm/L (in the absence of hepatic or renal disease).
• Enteral nutrition can be started when bowel function returns, starting with oral clear liquids. If the patient cannot eat enough for 5-7 days, enteral nutrition should be started. Parenteral nutrition is indicated when enteral feeding is not possible, and it can be given through a peripheral or central vein. Complications of enteral and parenteral nutrition include nausea, vomiting, malabsorption, diarrhea, hepatic steatosis, cholestasis, and gastrointestinal atrophy.

Metabolic Response to Trauma and Nutritional Support for Surgical Patients

• Metabolic response to trauma refers to the body's reaction to injury or impact, such as surgery, burn, or sepsis.
• The metabolic response consists of two phases: Ebb and Flow. In the Ebb phase, the body tries to decrease energy consumption, characterized by an increase in pulse rate, respiratory rate, cardiac output, and hyperthermia.
• The Flow phase consists of two sub-phases: Catabolic and Anabolic. The Catabolic phase is characterized by a decrease in cardiac output, hypotension, weak pulse, decrease in O2 consumption, and hypothermia.
• The body needs glucose for energy, which is obtained through glycogenolysis and gluconeogenesis in the liver. Cortisol, aldosterone, and ADH hormones help provide glucose and increase Na and water retention.
• The body has three energy sources: glycogen in the liver, body fat, and protein in skeletal muscle.
• In case of prolonged trauma or starvation, the body starts cannibalizing itself, leading to a decrease in body weight, body fat, skeletal muscle wasting, and an increase in glucose in the blood.
• Nutritional therapy can be given orally, enterally (through the gastrointestinal route), or parenterally (through the venous system) to prevent or treat malnutrition.
• Malnourished patients make poor surgical candidates, and surgery causes a stress response that leads to hypermetabolic or catabolic response. Malnutrition increases the risk of post-operative complications.
• Nutritional methods include oral nutritional supplements, nasogastric tube feeding, gastrostomy feeding, jejunal feeding, and parenteral nutrition.
• Rapid recovery after surgery requires a decrease in Nil By Mouth time before surgery, carbohydrate loading before surgery, minimal surgery, rapid feeding after surgery, and early mobilization.
• Diagnostic points for malnutrition include BMI < 20 kg/m2, weight loss > 10% of body weight over the last 3 months, and albumin serum level < 30gm/L (in the absence of hepatic or renal disease).
• Enteral nutrition can be started when bowel function returns, starting with oral clear liquids. If the patient cannot eat enough for 5-7 days, enteral nutrition should be started. Parenteral nutrition is indicated when enteral feeding is not possible, and it can be given through a peripheral or central vein. Complications of enteral and parenteral nutrition include nausea, vomiting, malabsorption, diarrhea, hepatic steatosis, cholestasis, and gastrointestinal atrophy.