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

S Rivas1, F Hernández, L Martínez

  • 1Dpto. de Cirugía Pediátrica, Hospital Universitario Infantil La Paz, Madrid.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|February 27, 2003
PubMed
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Controlled enteral nutrition significantly reduced bacterial translocation and infection rates in burned children. This approach improved outcomes compared to previous methods without nutritional control, highlighting its importance in pediatric burn care.

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:

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  • 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.