Many traumatically injured patients can tolerate a regular diet. For various reasons, however, patients may be subjected to frequent holding of oral intake for procedures, recovery periods after procedures, decreased appetite due to medications, etc. Supplementation drinks when a patient is eating can help bridge some of the caloric deficits and provide nutritional therapeutic benefits missed during the time-limited periods of inadequate intake.
- Recommended high-protein drinks (e.g., Ensure Plus®, Boost Plus®, Impact© Advanced Recovery™, or equivalent) can be administrated at 0.5–1.0 L per day (2–4 drinks) in addition to meals.
- There is no evidence of benefit of routine enteral supplementation in nutritionally low risk patients with intermittent brief (<48 hours) periods of NPO status.
- For moderate and high nutritional risk patients or pre-existing malnutrition, supplemental oral nutritional intake between NPO periods should be maximized and TPN considered if oral intake is inadequate or evidence of worsening nutritional parameters (e.g., weight loss, decline in pre-albumin, muscle loss).