Feed the gut, feed early and with the right stuff, but do not forget total parenteral nutrition

Excerpt

Our recent article published in the European Journal of Trauma and Emergency Surgery [ 1] on nutrition support was widely downloaded by our readers, which gave the editors of the journal indications that there is a need for a focused issue on the nutrition support of trauma and critically ill patients. Professor Uranues and myself asked expert clinicians from different parts of the world to put together a number of articles that will shed light on the current principles and practices of the nutrition support of critically ill and injured patients. What we received are outstanding reviews of current evidence that we hope will serve clinicians around the world and, in particular, our trauma community to provide better care to our injured and critically ill patients. While nutrition support has changed dramatically in the recent two to three decades, it is imperative that, in order to improve our practice of nutritional support for trauma and critically ill patients, we should continue to pursue further understanding of their metabolism, energy requirements and specific requirements of each nutrient, and not rely on old dogma and guidelines established by experts’ opinions and semi-quasi data. Specifically, we need to continue to challenge the current understanding of nutritional science, the biology of nutrients and the interaction of these nutrients with trauma, injury and critical illness, and how to further advance timely and disease-directed nutritional support. In the meantime, we need to provide nutritional support to critically ill or injured patients early and we need to do it right [ 2], and we should tailor nutritional formulas based on the content of the nutrient compositions [ 3‐ 5]. …