Question

A 28 year old is admitted to the hospital following a car accident in which several bones were broken and third-degree burns (15% body surface area[BSA]) were suffered. The patient is able to consume solid foods but is frequently out of the hospital room for diagnostic tests or therapy when the food trays arrive. The effect on the patient's nutritional status would be:

		minimal during the first few weeks of recovery
		rapid depletion of body fat stores
		none; the patient should be receiving total parenteral nutrition because of the injuries
		likely inadequate food intake, which could delay wound healing and compromise the patient's prognosis

Answer 1

Option d.is correct for the above mentioned case ie. Likely inadequate food intake, which could delay wound healing and compromise the patients prognosis because.

• After an injury hypermetabolism accelerated catabolism and excessive nitrogen loss continue for at least 2 weeks. It varies from patient to patient and can be affected by infection or sepsis in case of burns or multiple fractures.
• Trauma due to an accident, thermal burns, infection, sepsis elicit a hypermetabolic response. The more severe is the trauma, the more intense is the metabolic response.
• Increased protein catabolism is met by breakdown of muscle proteins resulting in weight loss.
• Stimulated protein breakdown is associated with a change in synthesis rate in the body mass and this results in a negative nitrogen balance indicating loss of proteins derived from muscle and viscera which may be improved by enteral feeding.
• The key factor in nutritional care are maintenance of energy, fluid and electrolyte balance and adequate nutrient and protein intake to promote wound healing.