Research progress in trauma metabolism and nutrition

Abstract

Trauma causes a series of alterations in body metabolisms, which may further aggravate organ dysfunction and lead to multiple organ failure (MOF). The typical metabolic responses to trauma can be summarized in six points: increased energy expenditure, accelerated gluconeogenesis, increased lipolysis, increased water-sodium retention, increased nitrogen excretion as well as decreased muscle protein synthesis. Nutrition support is critical in the management of trauma patients. The major functions of nutrition support are to prevent acute protein malnutrition, to modulate the immune response as well as to promote gastrointestinal structure and function. Despite the widespread use of nutrition in trauma patients, there still remains controversies in the aspect of the route and timing of nutrition support. In reviewing the literature studies concerning the route and timing of nutrition support in the trauma condition, we concluded that: First, enteral nutrition is superior to parenteral nutrition in critically ill trauma patients; Second, early enteral nutrition (within 24-48h after admission to ICU) was more preferred compared with delayed enteral nutrition.