Let us look briefly at some of the nutritional needs involved when one undergoes a major injury such as extensive burns, surgery or even Gunshot wounds. Many times nutrition is the last thing on our minds when a loved one gets seriously injured, but it plays a vital role in the recovery process.
Definition of terms you may have heard in relation to nutrition and major injuries
Sepsis – a serious medical condition characterized by whole body inflammatory state & the presence of a known or suspected infection (SIRS)
Trauma – any physical damage to the body caused by violence or accident or fracture, An emotional wound or shock often having long lasting effects.
Amino Acid – the chemical units or building blocks of the body that make up protein
Essential Amino Acid – amino acids that must be obtained from the diet
Branched Chain Amino Acids – a group of 3 essential amino acids important in supporting muscle growth & repair (leucine, isoleucine and valine)
The Body’s Nutritional Needs During Injury
The body needs a certain amount of nutrients to maintain a constant, healthy state, this need is determined by the basal metabolic rate (BMR- the amount of energy expressed in calories that a person needs to keep the body functioning at rest).
Any external or internal trauma raises the metabolic rate, and greater amounts of oxygen and nutrients are required to supply enough fuel and amino acids for repair and recovery.
Energy expenditure may rise by 10 – 50% to support the intense metabolic workload (Omerbegovic M et al 2003)
Protein and amino acid requirements increase to:
Positive Nutritional Balance
A positive nutritional balance is reflected:
Population studies indicate that 9 – 44% of people with wounds and surgical trauma are malnourished (Reid CL 2004)
The condition often goes unrecognized and untreated in hospitals, biologically, it is difficult to achieve usual levels of nutrition after major trauma because many important nutrients are channelled into the healing effort. Whereas good nutrition facilitates healing, malnutrition delays, inhibits and complicates the process (Williams and Leaper 2000). Nutritional support is fundamental to patient care and needs vary on an individual patient basis.
Many trauma patients suffer from
Effects of Trauma on Metabolism
During trauma, proteins, including muscle mass, are broken down to yield as much as 30% of caloric needs
Even when nutrients are supplemented, proteins will be utilized to provide 20 – 25% of caloric needs.
It is critical that trauma patients maintain an adequate supply of protein and calories to protect their lean muscle mass and supply their healing body with necessary nutrients.
Definition of terms you may have heard in relation to nutrition and major injuries
Sepsis – a serious medical condition characterized by whole body inflammatory state & the presence of a known or suspected infection (SIRS)
Trauma – any physical damage to the body caused by violence or accident or fracture, An emotional wound or shock often having long lasting effects.
Amino Acid – the chemical units or building blocks of the body that make up protein
Essential Amino Acid – amino acids that must be obtained from the diet
Branched Chain Amino Acids – a group of 3 essential amino acids important in supporting muscle growth & repair (leucine, isoleucine and valine)
The Body’s Nutritional Needs During Injury
The body needs a certain amount of nutrients to maintain a constant, healthy state, this need is determined by the basal metabolic rate (BMR- the amount of energy expressed in calories that a person needs to keep the body functioning at rest).
Any external or internal trauma raises the metabolic rate, and greater amounts of oxygen and nutrients are required to supply enough fuel and amino acids for repair and recovery.
Energy expenditure may rise by 10 – 50% to support the intense metabolic workload (Omerbegovic M et al 2003)
Protein and amino acid requirements increase to:
- Support formation of new tissues and rapid growth and multiplication of immune cells
- Maintain lean body mass (or muscle protein)
- Replace the protein lost to perspiration, bleeding, and excretion.
Positive Nutritional Balance
A positive nutritional balance is reflected:
- In rapid healing of wounds
- An efficient immune response
- The absence of infections or sepsis
- Maintenance of a lean body mass
Population studies indicate that 9 – 44% of people with wounds and surgical trauma are malnourished (Reid CL 2004)
The condition often goes unrecognized and untreated in hospitals, biologically, it is difficult to achieve usual levels of nutrition after major trauma because many important nutrients are channelled into the healing effort. Whereas good nutrition facilitates healing, malnutrition delays, inhibits and complicates the process (Williams and Leaper 2000). Nutritional support is fundamental to patient care and needs vary on an individual patient basis.
Many trauma patients suffer from
- Altered levels of consciousness
- Poor appetite
- Reduced digestive function
- Compromised blood circulation
- Radical alteration of normal daily routines
Effects of Trauma on Metabolism
During trauma, proteins, including muscle mass, are broken down to yield as much as 30% of caloric needs
Even when nutrients are supplemented, proteins will be utilized to provide 20 – 25% of caloric needs.
It is critical that trauma patients maintain an adequate supply of protein and calories to protect their lean muscle mass and supply their healing body with necessary nutrients.
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