RESUMO
Nutritional support must be an integral part of the management of trauma victims. This article compares the stress response, a maladaptive response, and starvation, an adaptive process, examines the clinical research regarding total parenteral nutrition and total enteral nutrition, provides an evidence-based approach to initiating nutritional support in critically injured patients, and discusses considerations in selecting nutritional formulas.
Assuntos
Cuidados Críticos/métodos , Estado Terminal , Traumatismo Múltiplo/complicações , Distúrbios Nutricionais/terapia , Adolescente , Alimentos Formulados , Humanos , Masculino , Monitorização Fisiológica/métodos , Monitorização Fisiológica/enfermagem , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Avaliação Nutricional , Distúrbios Nutricionais/diagnóstico , Distúrbios Nutricionais/etiologia , Distúrbios Nutricionais/metabolismo , Apoio Nutricional/métodos , Apoio Nutricional/enfermagem , Equipe de Assistência ao Paciente , Seleção de Pacientes , Fatores de TempoRESUMO
A 38-year-old, morbidly obese woman underwent surgery for debridement of necrotizing fasciitis of the abdominal wall. A pulmonary artery catheter was placed because of increasing fluid requirements. Despite multiple debridements and fluid resuscitation, the patient exhibited severe systemic inflammatory response. It was discovered that fluid placed in the introducer had extravasated into the subcutaneous tissues. In this obese patient, the pulmonary artery introducer was too short.
