Nutritional support of the pediatric trauma patient.
Of all the interventions available to aid recovery of the injured child, few have the power of proper nutritional support. Healing after trauma depends not only on restoration of oxygen delivery, but on "substrate delivery," or provision of calories to support metabolic power and specific nutrients to allow rebuilding of injured tissue. Failure to deliver adequate substrate to the cells is revealed as another form of shock. Nutritional interventions after trauma are most effective when informed by the specific ways that children diverge physiologically (metabolic rate, biomechanics, physiological response to trauma) from adults. This review describes these responses and outlines a general strategy for safely delivering energy and specific substrates to protect and heal injured children, regardless of body size and type of injury.
Cook
Robin C
RC
Department of Clinical Nutrition, The Children's Hospital of Philadelphia, 34th St. and Civic Center Blvd., Philadelphia, PA 19104, USA.
Blinman
Thane A
TA
D000975:Antioxidants / Q000008:administration & dosage; D002395:Catecholamines / Q000097:blood; D002648:Child; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004734:Energy Metabolism; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005934:Glucagon / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008894:Milk Proteins / Q000008:administration & dosage; D018529:Nutritional Support / Q000379:methods*; D000067816:Whey Proteins; D014947:Wounds and Injuries / Q000628:therapy*
D000975:Antioxidants; D002395:Catecholamines; D004044:Dietary Proteins; D015525:Fatty Acids, Omega-3; D008894:Milk Proteins; D000067816:Whey Proteins; D005934:Glucagon; D006854:Hydrocortisone