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Early Initiation of Enteral Nutrition Improves Outcomes in Burn Disease

早期開始的腸道營養改善燒傷的結果

Abstracts


Background: Burned patients have increased level of mortality, possibly due to late introduction of enteral feeding. The aim of this study was to compare the benefits and safety of very early enteral nutrition introduction compared to the normal diet among burns patients in an intensive care unit. Participants and Methods: Participants consisted of 101 patients, aged 20-76 years (mean age 48 years), 49 men and 52 women, with burns that covered more than 20% of the body. The intervention group consisted of 52 subjects fed via introduced nasojejunal probe that started within four hours after admission to the hospital. The control group consisted of fifty patients fed in standard manner per os (three standard hospital meals) immediately after the first wound dressing. Results: The average decline BMI in control group was 2.27±0.56 kg/m^2, while the average reduction in BMI in the intervention group was 1.77±0.38 kg/m^2 (p<0.001). The largest drop of albumin concentration in the control group was 28.5%, whereas in the intervention group was 23.8%. (p<0.001). The greatest decrease of transferrin concentration in the control group was 31.1%, while the average reduction in the intervention group was 18.3%. (p<0.001). C-reactive protein values were statistically higher in control group (p<0.001). Intervention group had lower rate of complications and infection rates. Conclusion: Enteral nutrition in burned patients should begin within few hours of burn onset. Such approach leads to better outcomes, reduces complications, and improves nutritional profile.

Keywords

燒傷 腸道營養 發炎 白蛋白 感染

Parallel abstracts


Background: Burned patients have increased level of mortality, possibly due to late introduction of enteral feeding. The aim of this study was to compare the benefits and safety of very early enteral nutrition introduction compared to the normal diet among burns patients in an intensive care unit. Participants and Methods: Participants consisted of 101 patients, aged 20-76 years (mean age 48 years), 49 men and 52 women, with burns that covered more than 20% of the body. The intervention group consisted of 52 subjects fed via introduced nasojejunal probe that started within four hours after admission to the hospital. The control group consisted of fifty patients fed in standard manner per os (three standard hospital meals) immediately after the first wound dressing. Results: The average decline BMI in control group was 2.27±0.56 kg/m^2, while the average reduction in BMI in the intervention group was 1.77±0.38 kg/m^2 (p<0.001). The largest drop of albumin concentration in the control group was 28.5%, whereas in the intervention group was 23.8%. (p<0.001). The greatest decrease of transferrin concentration in the control group was 31.1%, while the average reduction in the intervention group was 18.3%. (p<0.001). C-reactive protein values were statistically higher in control group (p<0.001). Intervention group had lower rate of complications and infection rates. Conclusion: Enteral nutrition in burned patients should begin within few hours of burn onset. Such approach leads to better outcomes, reduces complications, and improves nutritional profile.

Parallel keywords

burn enteral nutrition inflammation albumins infections

References


Sheridan RL. Burns. Crit Care Med. 2002;30:500-14. doi: 10.1097/00003246-200211001-00015
Svoboda P, Kantorova I, Ochmann J. Dynamics of interleukin 1,2 and 6 and tumor- necrosis factor α in severe burn patients. J Trauma. 1994;36:336-40. doi: 10.1097/00005373- 199403000-00009
Ryan CM, Schoenfelt DA, Thorpe WP, Sheridan RL, Cassem EH, Tompkins RG. Objective estimates of the probability of death from burn injuries. N Engl J Med. 1998;338: 362-6. doi: 10.1056/NEJM199802053380604
Sanderson IR. The anti-inflammantory effects of enteral nutrition. J Parenter Enteral Nutr. 2005;29:134-40. doi: 10.1 177/01486071050290S4S134
Wildhaber BE, Spencer AK. Lack of enteral nutrition – effects on the intestinal immnune system. J Surg Res. 2005; 123:8-16. doi: 10.1016/j.jss.2004.06.015

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