Nutritional Needs of Trauma Patients: Challenges, Barriers, and Solutions

Introduction: Hyperglycemia is a common problem encountered in hospitalized patients, especially in critically ill patients due to stress and using parenteral nutrition. Uncontrolled hyperglycemia may be associated with increased infection risk. The principal benefit of intensive insulin therapy is a decrease in infection-related complications and mortality. The aim of this study was the assessment of IIT effect on pathogen growth in ICU patients. Materials and Methods: We conducted a randomized controlled trial study where patients with brain trauma in grade 2 and 3 that received at least 50% of nutritional needs from parenteral nutrition. They randomly assigned to receive IIT or conventional glucose control. Pathogen growth, mortality, survival, APACHE II score, duration of hospital stay was assessed. Results: Of 29 patients randomized, 26 patients completed the study. Survival duration, ventilator dependency and pathogen growth was improved in tight control group but not significant between two groups due to low sample size. Conclusion: In our study, IIT reduced pathogen growth without hypoglycemic episodes in head trauma patients.[GMJ. 2012;1(1):2-7]

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Aetiology and Prognostic Implication of Severe Jaundice in Surgical Trauma Patients

Scandinavian Journal of Gastroenterology ◽

10.1080/00365520310000519 ◽

2003 ◽

Vol 38 (1) ◽

pp. 102-108 ◽

Cited By ~ 10

Author(s):

K. J. Labori ◽

B. A. Bjørnbeth ◽

M. G. Ræder

Keyword(s):

Surgical Trauma ◽

Trauma Patients ◽

Prognostic Implication ◽

Severe Jaundice

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Venous thromboembolism in a general hospital. An update with low molecular weight heparin prophylaxis

VASA ◽

10.1024/0301-1526.36.1.17 ◽

2007 ◽

Vol 36 (1) ◽

pp. 17-22

Author(s):

Schulz ◽

Kesselring ◽

Seeberger ◽

Andresen

Keyword(s):

Molecular Weight ◽

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Low Molecular Weight ◽

Trauma Patients ◽

Vte Prophylaxis ◽

Vein Thrombosis ◽

Patients At Risk ◽

Hospital Stays ◽

Event Rates

Background: Patients admitted to hospital for surgery or acute medical illnesses have a high risk for venous thromboembolism (VTE). Today’s widespread use of low molecular weight heparins (LMWH) for VTE prophylaxis is supposed to have reduced VTE rates substantially. However, data concerning the overall effectiveness of LMWH prophylaxis is sparse. Patients and methods: We prospectively studied all patients with symptomatic and objectively confirmed VTE seen in our hospital over a three year period. Event rates in different wards were analysed and compared. VTE prophylaxis with Enoxaparin was given to all patients at risk during their hospital stay. Results: A total of 50 464 inpatients were treated during the study period. 461 examinations were carried out for symptoms suggestive of VTE and yielded 89 positive results in 85 patients. Seventy eight patients were found to have deep vein thrombosis, 7 had pulmonary embolism, and 4 had both deep venous thrombosis and pulmonary embolism. The overall in hospital VTE event rate was 0.17%. The rate decreased during the study period from 0.22 in year one to 0,16 in year two and 0.13 % in year three. It ranged highest in neurologic and trauma patients (0.32%) and lowest (0.08%) in gynecology-obstetrics. Conclusions: With a simple and strictly applied regimen of prophylaxis with LMWH the overall rate of symptomatic VTE was very low in our hospitalized patients. Beside LMWH prophylaxis, shortening hospital stays and substantial improvements in surgical and anasthesia techniques achieved during the last decades probably play an essential role in decreasing VTE rates.

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