A 22-year-old female who has sustained a 50% total body surface area burn in a house fire is intubated in the ICU. She is scheduled for serial debridements in the OR. The best management for perioperative nutrition includes:A. Begin TPN to ensure adequate nutrition despite intermittent NPO periods
Correct Answer: B
A metaanalysis in 2003 did not find a decreased risk for aspiration with prolonged NPO. Protein-calorie malnutrition has been linked to worse outcomes with respect to ventilator-free days, ICU and hospital LOS, wound healing, and mortality. Continuing tube feeds despite trips to the OR is the best choice for nutrition management in this scenario. There is no indication to initiate TPN at this time.