Medicina intensiva
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Patients with polytrauma can be viewed as paradigmatic of the critically-ill patient. These previously healthy patients undergo a life-threatening aggression leading to an organic response that is no different from that in other types of patients. The profile of trauma patients has changed and currently corresponds to patients who are somewhat older, with a higher body mass index and greater comorbidity. ⋯ Therefore, early nutritional support, preferentially through the enteral route, with appropriate protein intake and glutamine supplementation, provides advantages over other routes and types of nutritional formula. To avoid overnutrition, reduced daily calorie intake can be considered in obese patients and in those with medullary lesions. However, little information on this topic is available in patients with medullary lesions.
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The use of noninvasive mechanical ventilation was evaluated in our series of patients admitted to our ICU with pneumonia due to influenza A virus H1N1, assessing the need for intubation, arterial blood gases and clinical improvement, the development of complications and ICU and hospital stay. ⋯ Based on our results, increased use of noninvasive mechanical ventilation in future epidemics coujld be proposed.