Explain Nutrient Requirement and Dietary Management?
You must have understood by the discussion above that by the end of the flow phase, the patient usually is well hydrated and has body weight close to the pre-injury weight. The return of bowel movements is an indication that the patient can now be slowly introduced to nutrition support in the form of oral intake, enteral feeds or parenteral nutrition. A combination of any two alterations in these routes is required on a day-to-day basis depending upon the changing clinical parameters and the severity of bums. Dietary management should be such as to fulfil the following objectives:
- providing enough calories to prevent subsequent weight loss
- Maintaining fluid and electrolyte balance - minimizing stress response to pain and anxiety - maintaining a positive nitrogen balance
- replenishing the depleted reserves of vitamins and minerals
- preventing curling's ulcers, ileus and other complications
As always we shall first discuss about the energy requirements of the patient during the flow and anabolic phase. Thereafter we shall learn about the contribution of various macronutrients for providing the required amount of calories.