ASSESSING THE EFFICACY OF NUTRITIONAL SUPPORT

This review outlines the conventional methods of assessing nutritional status and their limitations in the presence of acute trauma and seps is. It also discusses the problems of attempting to improve or at leas t maintain nutritional status in the presence of an inflammatory stimu lus. Most of the conventional markers of nutritional status are altere d in trauma and sepsis with decreases in plasma protein concentrations and muscle strength, an apparent depression of immune function and an increase in extracellular fluid volume. It also appears to be impossi ble to improve nutritional status in the presence of a severe inflamma tory stimulus, and the most one can hope for is to attenuate the rate of decline. The evidence for these observations is discussed.