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[Nutritional support in burnt patients]
T Grau Carmona1, M D Rincón Ferrari, D García Labajo
1Hospital Universitario 12 de Octubre. Madrid.
Nutricion Hospitalaria
|June 29, 2005
Summary
Thermal injury causes a significant hypermetabolic response in critically ill patients. Early enteral nutrition with increased calories, protein, and specific supplements like arginine, glutamine, vitamins A and C, and zinc is crucial for recovery.
Area of Science:
- Metabolic response to injury
- Nutritional support in critical care
Context:
- Thermal injury induces a severe hypermetabolic state, one of the highest observed in critically ill patients.
- Accurate measurement of energy expenditure via indirect calorimetry is essential for burn patients.
- When indirect calorimetry is unavailable, established formulas can estimate energy needs.
Purpose:
- To outline optimal nutritional strategies for patients with thermal injuries.
- To emphasize the importance of early and enteral nutrition.
- To provide guidance on caloric, protein, and micronutrient intake.
Summary:
- Nutritional therapy should be initiated early, preferably enterally.
- Caloric intake should exceed recommendations for other critically ill patients but not surpass 200% of basal energy expenditure.
- A hyperproteic diet is recommended, along with specific nutrients like arginine, glutamine, vitamin A, vitamin C, and zinc to support wound healing.
Impact:
- Optimized nutritional management can significantly improve outcomes for burn patients.
- This guidance aids clinicians in providing evidence-based nutritional support.
- Adequate nutrition is vital for mitigating hypermetabolism and promoting recovery from thermal injury.