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“We didn't know if she was going to live.”
David Chirico

It’s the call every parent dreads. David Chirico, a Nestlé Health Science employee, picked up his cell phone to hear his wife Rachel’s frantic voice: “Maggie’s been in a car accident. We need to get to her right away!” The family rushed to Virginia, 500 miles from their Connecticut home.

Maggie's accident resulted in a traumatic brain injury


Maggie had been thrown from a car that overturned, suffering multiple life-threatening injuries, including a traumatic brain injury. Incredibly, she made a full recovery from trauma, and during this time her family made sure she received the specialized nutrients her body needed from IMPACT® Peptide 1.5 Formula and IMPACT Advanced Recovery® Immunonutrition Drink.

Less than a year later, Maggie and her family sat down with a group of Nestlé employees as part of the company’s Connections program to talk about their difficult journey. Dr. Juan Ochoa, Chief Medical Officer of Nestlé Health Science North America, was on hand to provide his medical insights.

Prioritizing Maggie’s injuries

In the serious collision, Maggie had been thrown 30 feet from the car and suffered a traumatic brain injury, lacerations to her liver and spleen, broken ribs and wrist, fractures to her skull and hip, and a punctured/collapsed lung. According to Dr. Ochoa, for trauma patients like Maggie, there is a detailed protocol to ensure that nothing is missed.

The first thing medical personnel do is to conduct what they call a primary survey to provide an initial quick check to determine if there are any life-threatening injuries. In Maggie’s case, she had a collapsed lung, so they inserted an endotracheal tube to ensure that she could breathe.

The hospital team then moved onto the secondary survey, which is a more detailed and thorough examination to identify injuries. The chief concern was Maggie’s traumatic brain injury. Soon after being hospitalized, Maggie had an operation to reduce the swelling on her brain, and a scalp reassignment (skin grafts are taken from other areas of her body) to cover the part of her skull that had been exposed when she skidded on the pavement.

Nutritional therapy during recovery from trauma

Once the major injuries were attended to, it was time to focus on the finer details, like nutritional therapy, which can play an important role for the trauma patient. “Early nutrition is a big goal. We know that the sooner we start, the better,” says Dr. Ochoa. In fact, critical care guidelines1 suggest enteral nutrition (EN) feeding as early as 24-48 hours after severe trauma for patients who cannot feed themselves.

Before the accident, Maggie was a healthy and well-nourished young woman. But during recovery from trauma, she had special nutritional needs. “It’s not just a matter of getting adequate calories,” says Dr. Ochoa, “it’s about making sure she has the right nutrients to fuel her metabolism to support her body during the healing process. Traumatic brain injury can also raise blood sugar levels which can make people more prone to infections. So, we have to watch her glucose levels. Her body has a big job to do.”

The right nutritional therapy can help by providing the body with specific nutrients it needs to:

The right nutritional therapy can help by providing the body with specific nutrients


Critical Care guidelines recommend a nutritional formula for people recovering from a traumatic brain injury1, which includes arginine with other agents such as:

nutritional formula for people recovering from a traumatic brain injury

Nutritional therapy was important in Maggie’s recovery from trauma

In the weeks following the accident, Maggie received her nutrients through a feeding tube containing IMPACT® Peptide 1.5 formula. The unique blend of ingredients in IMPACT® Peptide 1.5 formula, including arginine, omega-3 fatty acids and nucleotides, has been shown to support the immune system for surgical and trauma patients.2,3 Later, when she could drink on her own, she continued to receive this same blend of nutrients with IMPACT Advanced Recovery® drink.

Dr. Ochoa believes that specialized nutrition plays an important role during recovery from trauma. “When you have the optimal nutrition, you see the difference,”2,3 says Dr. Ochoa.

A dietitian in Maggie’s court

Maggie was fortunate that her father, David, is a registered dietitian who works for Nestlé Health Science, the company that makes IMPACT® formulas. “When I first got there, I asked a lot of questions. Once she was stabilized, I wanted to make sure she was getting the best nutrition possible. And because of the phenomenal team within Nestlé Health Science, I felt like I had an army of clinicians behind me,” says David. Read David’s advice for advocating for your loved one in the hospital after a traumatic brain injury.

Maggie is back to being a healthy and active young woman

Maggie is living the life of a busy 22-year-old, juggling work, school, and a social life. She reflects on the day she knew it was all going to be okay: “I remember when the physical therapist wheeled me outside to the courtyard for the first time. When that sun hit my skin for the first time in weeks, I just sat there and I took it all in. And I thought: I’m ready to go home.”




  1. McClave SA et al. JPEN 2016; 40(2):159-211.
  2. Braga M et al. Surg 2002; 132:805-814.
  3. Farber MS et al. JPEN 2005:29 (1 Suppl):S62-69