Dietitian perspectives of nutrition support practices in major burn injuries

To quantify dietitians' perceptions of current nutrition support practices across national burns centres.

Quantitative online survey, disseminated via a national burn association to registered burn centres. Participants included dietitians involved in the management of adult inpatients with major burns (≥20% total body surface area).

Final analysis included 15 survey responses. Enteral nutrition was the most common route of nutrition support (n = 11, 73%), with gastric feeding the primary preferred method (n = 10, 67%). Post-pyloric feeding was typically indicated by feed intolerance (n = 11, 79%). Intra-operative feeding was rarely (n = 5, 33%) or never (n = 5, 33%) used, reportedly due to airway safety concerns (n = 6, 40%). Energy requirements were determined using a combination of predictive equations and indirect calorimetry (n = 8, 57%), with a modified Schofield equation the most common predictive equation used (n = 9, 75%). Protein requirements were calculated at 1.5-2.0 g/kg/day by 10 (71%) respondents. Micronutrient supplementation practices were varied.

Across hospitals in the region that manage patients with major burn injures similarities in practice relate to route of nutrition and methods for estimating energy and protein requirements. Inconsistency in practice relating to the use of, and reported barriers to, intra-operative feeding and micronutrient supplementation were reported.