D Malnutrition
Definition
Malnutrition, or nutritional failure, is associated with protein depletion in the presence of adequate calories or with combined protein-calorie deficiency. Protein-calorie depletion is a frequent finding in surgical patients and in critically ill individuals.
Incidence and prevalence
Critically ill patients experience negative caloric intake because of the hypermetabolic state produced by their illness. Trauma, fever, sepsis, and wound healing result in a drastically increased metabolism.
Pathophysiology
Basic energy requirements are an intake of 1500 to 2000 calories/day. An increase in body temperature of 1° C increases daily caloric requirements by 15%. Multiple fractures increase energy needs by 25%. Major burns cause the greatest increase in energy requirements: 100%. In addition, patients with large tumors may also have greatly increased energy requirements.
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