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Nutrition and the open abdomen.
Nathan J Powell1, Bryan Collier
1Vanderbilt University School of Medicine, Nashville, TN, USA.
Summary
Optimal nutrition support is vital for patients with an open abdomen. This review clarifies early enteral nutrition (EN) benefits and addresses concerns, offering an algorithm for managing these critically ill surgical patients.
Area of Science:
- Critical care medicine
- Surgical nutrition
- Trauma surgery
Background:
- Open abdomen management presents unique nutritional challenges.
- Provider concerns and controversies exist regarding early enteral nutrition (EN) in open abdomen patients.
- Altered metabolic requirements necessitate specialized nutritional strategies.
Purpose of the Study:
- To review clinical concepts of the open abdomen.
- To examine altered nutrition requirements in patients with a temporary laparostomy.
- To provide guidance on nutrition support for open abdomen management.
Main Methods:
- Literature review of clinical concepts and nutrition support in open abdomen.
- Examination of altered nutrition requirements and metabolic changes.
- Development of a nutrition support algorithm for open abdomen patients.
Main Results:
- Early enteral nutrition (EN) is supported by literature, despite provider concerns.
- Supplemental parenteral nutrition is considered for patients not meeting goals enterally.
- An algorithm is provided to guide nutrition support decisions.
Conclusions:
- Adequate nutrition support, particularly early EN, is critical for open abdomen patients.
- Addressing provider concerns and understanding altered requirements are key.
- A structured algorithm aids in managing nutrition for these complex surgical patients.
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