This document discusses the nutritional needs of patients with sepsis, trauma, or burns who are in a hypermetabolic state with high metabolic demands. It outlines the objectives of nutritional support which are to detect and correct any preexisting malnutrition, prevent further protein-calorie malnutrition, and optimize the patient's metabolic state through fluid and electrolyte management. The goals are to meet the high substrate demands to support hypermetabolism and prevent catabolism while reversing any malnutrition.