TABLE B-1 Content of Evidence-Based Guidelines (EBG) for Acute Traumatic Brain Injury (TBI) in Intensive Care Unit (ICU) Setting (e.g., Critical Illness)

Guideline/Step of Care Process with Nutrition Implications

Brain Trauma Foundation (BTF) Guidelines for the Management of Severe Traumatic Brain Injurya

American Society for Parenteral and Enteral Nutrition Critically Ill Patientb

Nutrition-related assessment information

 

A1. Traditional nutrition assessment tools (albumin, pre-albumin, and anthropometry) are not validated in critical care. Before initiation of feedings, assessment should include evaluation of weight loss and previous nutrient intake prior to admission, level of disease severity, comorbid conditions, and function of the gastrointestinal (GI) tract. (Grade: E)

 

C1. The target goal of enteral nutrition (EN) (defined by energy requirements) should be determined and clearly identified at the time of initiation of nutrition support therapy. (Grade: C) Energy requirements may be calculated by predictive equations or measured by indirect calorimetry. Predictive equations should be used with caution, because they provide a less accurate measure of energy requirements than indirect calorimetry in the individual patient. In the obese patient, the predictive equations are even more problematic without availability of indirect calorimetry. (Grade: E)



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