[Decrease in bacterial translocation in burned children treated with controlled nutritional support]

Area of Science:

• Pediatric critical care medicine
• Infectious disease epidemiology
• Nutritional support in trauma

Background:

• Epithelial barrier dysfunction in enteric cells facilitates bacterial translocation, leading to local and systemic infections.
• Burn injuries, particularly those exceeding 10% total body surface area (TBSA), pose a significant risk for infectious complications.
• Enteral nutrition is a crucial component of managing pediatric burn patients.

Purpose of the Study:

• To evaluate the incidence of infections in pediatric burn patients receiving controlled enteral nutrition.
• To compare infection rates between patients receiving enteral nutrition and a historical cohort without controlled nutrition.
• To assess the impact of nutritional support on bacterial translocation in pediatric burn patients.

Main Methods:

• Prospective study of 50 pediatric burn patients (0-14 years) with TBSA > 10%.
• Bacteriological cultures obtained weekly from admission to discharge.
• Nutritional requirements determined by calorimetry, with support via nasoduodenal tube.

Main Results:

• A prospective group (Group 1) on enteral nutrition had 6% positive blood cultures and 28% local infections.
• A retrospective group (Group 2) without controlled nutrition had 11.3% positive blood cultures and 50% local infections.
• Statistically significant improvements (p < 0.05) in systemic and local infection rates, and a decrease in enteric bacteria infections were observed with controlled nutrition.

Conclusions:

• Controlled nutritional support is a primary factor in improving infection rates in pediatric burn patients.
• Enteral nutrition effectively reduces bacterial translocation and associated infections.
• Optimized nutritional management is essential for better outcomes in pediatric burn care.