Nutrition in burns: need for an aggressive dynamic approach

Area of Science:

• Burn management
• Nutritional support
• Metabolic response

Background:

• Extensive burns trigger a hyper-metabolic state, leading to severe catabolism, lean body mass loss, and impaired immune function.
• The physiological derangements post-burn necessitate effective nutritional interventions to mitigate negative outcomes.

Purpose of the Study:

• To evaluate the efficacy of early nasogastric tube insertion in burn patients.
• To assess the impact of charting daily calorie intake and utilizing low-cost, locally relevant feeds on patient recovery.
• To determine optimal nutritional management strategies within a general hospital setting.

Main Methods:

• Prospective study of 138 burn cases (April 2003-March 2005) compared with 206 retrospective controls (April 2000-March 2003).
• Analysis focused on mortality rates, average hospital stay, and the number of procedures performed.
• Statistical comparison using Z-test and student t-test across different burn severity categories (% Total Body Surface Area - TBSA).

Main Results:

• Early nasogastric tube insertion, calorie charting, and low-cost feeds significantly reduced hospital stay and procedures in 20-39% TBSA burns.
• These nutritional strategies also led to a significant decrease in mortality, hospital stay, and procedures for 40-59% TBSA burns.

Conclusions:

• Implementing early nasogastric tube feeding and cost-effective, localized nutrition plans is crucial for improving burn patient outcomes.
• This nutritional management approach effectively reduces resource utilization and mortality in moderate to severe burn injuries.