Caroline is a 33-year-old female who was struck by a motor vehicle while she was bicycling. She suffered head and chest trauma as well as multiple broken bones. Caroline is in a medically induced coma in the intensive care unit following surgery and

Question

requires mechanical ventilation due to ARDS. She is being fed enterally. Her mother reports that she is 5'7" tall and weighs approximately 140 pounds.Why is Caroline likely to experience negative nitrogen balance despite being provided with adequate protein?

Answer 1

Even with adequate protein, negative nitrogen balance cannot be prevented during acute stress because hormonal changes encourage protein catabolism. The bed rest required during illness also contributes substantially to muscle breakdown.