OBJECTIVE: Nutrition support in the severely injured @entity130 @entity1 is crucial to minimize the hypermetabolic stress response. Even though enteral nutrition is the preferred method of feeding, it is not always feasible after @entity1230 . We present a complex nutritional case in a @entity1 who sustained severe @entity1661 with a severe @entity99 , @entity174 , and @entity358 . METHODS: The @entity1 required several repeat laparotomies, abdominal packing, and temporary abdominal closure. The clinical course was complicated by @entity551 requiring multiple vasopressors; @entity1003 requiring more than 35 U of packed red cells, more than 50 U of fresh frozen plasma, and more than 80 U of platelets; @entity810 requiring dialysis; and @entity55 and @entity649 requiring intricate ventilator management. Nutrition intervention began on post- @entity130 day 4 with total parenteral nutrition due to @entity551 , resuscitation, and massive bowel @entity4 ; by post- @entity130 day 8. the @entity1 was receiving goal nutrients. RESULTS: On post- @entity130 day 27, bowel @entity4 was significantly less, and a nasoenteric feeding tube was placed and enteral feeding initiated. By post- @entity130 day 31, full enteral feeds were tolerated, and total parenteral nutrition was stopped. Nutrient provision was adjusted daily to account for organ and metabolic changes including hepatic, pulmonary, and @entity8 . The @entity1 did well and was eventually extubated and eating a regular diet. CONCLUSION: With careful monitoring and adjusting of the nutritional plan, a @entity130 @entity1 with an open abdomen can be fed optimally, safely, and successfully despite increased bowel @entity4 and @entity881 .

Nutrition support for the @entity1 with an open abdomen after major XXXX .

@entity1 :: ('9606', 'Species') :: ['patient'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal dysfunction'] @entity174 :: ('MESH:D050723', 'Disease') :: ['rib fractures'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity649 :: ('MESH:D012128', 'Disease') :: ['acute respiratory distress syndrome'] @entity4 :: ('MESH:D004487', 'Disease') :: ['edema'] @entity1661 :: ('MESH:D000008', 'Disease') :: ['abdominal trauma'] @entity1003 :: ('MESH:D001778', 'Disease') :: ['coagulopathy'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity358 :: ('MESH:D008171', 'Disease') :: ['pulmonary contusion'] @entity1230 :: ('MESH:D009104', 'Disease') :: ['multiple trauma'] @entity810 :: ('MESH:D058186', 'Disease') :: ['acute renal failure'] @entity881 :: ('MESH:D009102', 'Disease') :: ['multiple organ dysfunction'] @entity99 :: ('MESH:D056486', 'Disease') :: ['liver injury'] @entity130 :: ('MESH:D014947', 'Disease') :: ['hypermetabolic complex trauma', 'trauma']
@entity1661 :: (MESH:D000008,Disease) :: ['abdominal trauma']
