Feeding Practices of Open Abdomen Patients: An Assessment of Energy Intake and Clinical Outcomes

Abstract

Implementation of damage control surgery and the open abdomen technique has showed improved survival in trauma and acute general surgery emergencies. However, this technique has also created new challenges in the management of patients with a significant abdominal wall defect. One of the main challenges lies in optimizing resting energy expenditure (REE). Thus, under-feeding or over-feeding remains problematic due to uncertainties regarding the prediction of energy needs at different disease states as well as individual variations. Early studies were conducted to explain the responses of injury and its influence on caloric and protein requirements. These studies showed that nutrition support after trauma should be dynamically adjusted according to metabolic responses. This is because the trauma itself can induce a series of dynamic metabolic responses with different characteristics in three stages: the ebb phase, flow phase, and recovery phase.