Prevention of upper gastrointestinal bleeding in burn patients: a role for 'elemental' diet

In a retrospective study, the role of the elemental diet in preventing upper gastrointestinal (GI) bleeding was evaluated in 146 severely burned patients. The patients were divided into two groups. Group A consisted of 77 patients with 20% to 80% body-surface-area burns who received the usual diet. Group B consisted of 69 patients with similar-sized burns receiving Vivonex as the elemental diet. In group A, the incidence of upper GI bleeding was 44%, major upper GI bleeding was 30%, and two patients required surgery. The incidence of upper GI bleeding in group B was 20%, major upper GI bleeding was 3%, and no patients required surgery. Group A had 55% mortality, and group B, 38% mortality. Vivonex was associated with a noticeable decrease in major upper GI bleeding in severely burned patients, and unlike antacid and cimetidine therapy, contributed concomitantly to increased caloric intake.