ABSTRACT
Trauma is accompanied by a set of metabolic aberrations that are profound but predictable. An understanding of the metabolic events that accompany trauma is the first step in nutritional support therapy. Nutritional support of the injured child should be instituted promptly and be designed to limit the deleterious consequences of structural protein loss while facilitating wound healing and the immune response. The metabolic response to major trauma is associated with a consistent hormonal and cytokine profile regardless of the specific pattern of injury. Once a decision has been made to commence nutritional support in the injured child, an accurate individualized determination of nutrient requirements is needed. This assessment should include estimates of protein, total energy, carbohydrate, lipid, electrolyte, and micronutrient needs. In the traumatized child, the enteral route of nutrient provision is preferable to the parenteral route whenever the gastrointestinal tract is functional. Enteral nutrition is physiologic, safer, and cheaper.
