Answer: a, b, c, d 99 Translocation is promoted in three general ways: 1) altered permeability of the intestinal mucosa as caused by shock, sepsis, distant injury, or cell toxins; 2) decreased host defense (secondary to glucocorticoid administration, immunosuppression, or protein depletion; and 3) an increased number of bacteria within the intestine. Because many factors that facilitate bacteria translocation occur simultaneously in surgical patients, these effects may be either additive or cumulative. In addition, many patients in Surgical Intensive Care Units do not generally receive enteral feedings and therefore current parenteral therapy results in gut atrophy which further promotes translocation. Which of the following statement(s) is/are true concerning nutritional support of the injured patient? a. The goal of nutritional support is maintenance of body cell mass and limitation of weight loss to less than 25% of preinjury weight b. Under-nutrition may compromise the patient’s available defense mechanisms c. Nutritional support is an immediate priority for the trauma patient d. Fifty percent of non-nitrogen caloric requirements should be provided in the form of fat