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Related Experiment Videos

Nutritional considerations for the burned patient.

P S Pasulka, T L Wachtel

    The Surgical Clinics of North America
    |February 1, 1987
    PubMed
    Summary
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    Severe injury triggers a catabolic state, increasing energy needs. Nutritional support for burn patients involves high caloric and protein intake, with careful consideration for safety and micronutrient supplementation.

    Area of Science:

    • Metabolic response to injury
    • Nutritional support in critical care

    Background:

    • Injury induces a hypermetabolic, catabolic state characterized by protein wasting.
    • Energy expenditure escalates with injury severity, peaking at double resting expenditure for 50% TBSA burns.

    Purpose of the Study:

    • To outline optimal nutritional recommendations for patients with severe burns.
    • To emphasize the balance between nutritional goals and patient safety.

    Main Methods:

    • Adopting nutritional guidelines from Boston Shriner's Burn Institute and Massachusetts General Hospital.
    • Calculating caloric needs at twice the resting energy expenditure (Harris-Benedict equation) for burns >30% TBSA.
    • Providing protein at 2.5 gm/kg/day based on ideal body weight.

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    Main Results:

    • Optimal caloric intake is twice the resting energy expenditure for severe burns.
    • Optimal protein intake is 2.5 gm/kg/day.
    • Multivitamin, vitamin C, and zinc supplementation may be beneficial but require further research.

    Conclusions:

    • Aggressive nutritional therapy is crucial for managing the hypermetabolic response to severe injury.
    • Established guidelines provide a framework for caloric and protein delivery.
    • Micronutrient therapy requires further investigation for efficacy and safety in stressed patients.