Nutritional support for trauma and critically ill patients has been advocated to promote
immune system recovery and to prevent as much tissue break down and nutritional deficit. The
present study aiming to assessment of the parenteral nutrition on the immune system of patient with
multiple trauma. Compare the effect of early parenteral nutritional and conventional hospital diet
0" the nutrition and ·immunology markers in trauma patients. A convenient sample of 40 severely
traumatized patients within 8 hours after trauma they were enrolled sequentially into conventional
(n = 20) and total parenteral nutrition (n= 20) groups (TPN). Criteria for subject inclusion were,
age 18· < 45 years, Injury severity score (ISS) 20-40 score. Tools of data collection, four tools
were utilized to collect data pertinent to the study. These tools were, nutritional assessment sheet,
trauma scales and (APACHE) score (checklist), parenteral nutrition plans, evaluation tool which
includes (Anthropometric measurement, Laboratory studies Immunological parameters). Total
parenteral nutritional has positive impact for trauma patients on anthropometric measurement,
(weight loss, TSF and MAC) which was observed at the end of therapy (7th day) for the
conventional group while there were no changes for the same parameters in TPN group. As regard,
laboratory tests, there were significantly increase in the values of total serum protein and albumin
among patients of the TPN group after the end of therapy at (7th day) .As regard immune function,
it was found that the mean values of (IL-lO, lL-6 , CD8) were significantly dropped in the TPN
group after the end 0'£ therapy as compared to the admission. Also there were significantly increase
in the values of complement C3, lOA, CD4, and CD4/CD8 ratio among patient of the TPN group at
(7th day). Establishment and implement of standardized protocol of parenteral nutrition support
using nutritional screening and physical assessment forms, for the critically ill patients.