The effectiveness of caloric value of enteral nutrition in patients with major burns

Enteral nutrition as an important component of modern treatment is mandatory for patients suffering from major bums. Regardless of the initial estimation of caloric requirements, actual daily volume of energy consumption may vary depending on the general condition of the patient and the side effects of enteral nutrition. The aim of our study was to investigate the relation between caloric value of enteral nutrition and treatment course. Methods: The prospective study involved 103 adult patients treated in the Hospital of Kaunas University of Medicine for 2 degrees-3 degrees bums of 10-80% body surface area from I January 2001 till 31 December 2003. All patients received enteral nutrition during the acute phase. After the completion of the treatment, caloric value of enteral nutrition was estimated, and patients were divided into two groups: group A received more than 30 kcal/(kg 24 h); and group B, received less than 30 kcal/(ka 24 h). We compared patients' mortality, complication rate, and hospital stay time. Results: The mortality of patients, who enterally received less than 30 kcal/(ka 24 h), was 32.6%, comparing to 5.3% mortality in patients who received 30 or more kcal/(kg 24 h) (p < 0.01). The caloric value of less than 30 kcal/(kg 24 h) increased the frequency of pneumonia by 2.0 times, and the frequency of sepsis by 1.8 times (p < 0.05). The duration of the treatment of survivors in this group was by 12.6 days longer (p = 0.01). Conclusions: The caloric value of enteral nutrition seems to be associated with patient mortality, complication rate, and treatment duration. The results of the treatment of patients who received more or 30 kcal/(ka 24 h) were much better. Because determined relationship may not be directly causal, further study is needed to determine whether active intervention to improve nutrition could improve outcomes. (c) 2005 Elsevier Ltd and ISBI. All rights reserved.