Effect of early enteral nutrition on morbidity and mortality in children with burns

Burns increase the metabolic demands of the body and can lead to severe weight loss and increased risk of death. Early enteral support is believed to improve gastrointestinal, immunological, nutritional and metabolic responses to critical injury; however, this premise is in need of further substantiation by definitive data. This research aimed to examine the effectiveness and safety of early enteral feeding in paediatric patients suffering from burns. Materials and methods: This clinical trial was carried out with a total number of 688 children with burns hospitalised in the Burn Department across a 2-year period (September 2002-September 2004). The subjects were randomised into two groups. A total of 322 patients received only intravenous resuscitation, in accordance with current treatment protocols, in the first 48 h and were considered as the late enteral nutrition group (LEN group); 366 patients were nourished early enteral nutrition group (EEN group), such that both groups received similar amounts of fluid in the first 48 h. Initiation of enteral nutrition commenced between 3 and 6 h following the burn. The patients were kept in the unit until they were discharged. Wound management did not vary between groups. Results: In our study, the mean age was 5 +/- 3 years in the LEN group and 5 +/- 3.5 years in the EEN group. Hot liquids were the most common cause of burns in both groups. The mean percentage of burn was reported as 20 +/- 13 in the LEN group and 22 +/- 15 in the EEN group. Mean duration of hospitalisation was 16.4 +/- 3.7 days in the LEN group and 12.6 +/- 1.3 in the EEN group for cured patients (P < 0.05). A total of 40 patients (12%) in the LEN group and 31 patients (8.5%) in the EEN group expired (P < 0.05). Conclusion: Our research showed that EEN decreases duration of hospitalisation and mortality in children with burns. (C) 2009 Elsevier Ltd and ISBI. All rights reserved.