Abstract
Introduction It has been proposed that nutritional therapy in critically ill patients after major burn reduces mortality. However, the actual practice of nutrient delivery, and the effect on outcome, has not been described. Study objectives To evaluate international practices related to nutritional support and outcomes in mechanically ventilated patients with burn injury. Methods Data from the International Nutrition Surveys (2007-2011) for patients with a primary diagnosis of burn were extracted and analysed. Results Eighty-eight of 90 patients (aged 16-84 years) received enteral nutrition. The median time for initiation of enteral feeding was 17 h [range 0-65]. Fifty patients (57%) had interruptions to nutrient delivery, most often these interruptions were fasting for operative procedures. There were substantive energy and protein deficits [943 (654) kcal/day and 49 (41) g/day, respectively; mean (SD)]. Nineteen (21%) patients died within 60 days of admission, and the energy and protein deficits were greater in those that died compared with survivors [died vs. survived, energy: 1251 (742) vs. 861 (607) kcal/d; p = 0.02; and protein 67(42) vs. 44(39) g/d; p = 0.03]. Energy and protein deficits were associated with increased mortality with the greater the deficit, the stronger the association with death (odds ratio for death: energy deficit/100 kcal 1.10 (1.01, 1.19); p = 0.028 and protein/10 g 1.16 (1.01, 1.33); p = 0.037). Results were similar and remained significant after adjusting for severity of illness. Conclusions Mechanically ventilated patients following burn develop substantial energy and protein deficits, with lesser deficits observed in survivors.
| Original language | English |
|---|---|
| Pages (from-to) | 510-518 |
| Number of pages | 9 |
| Journal | Burns : Journal of the International Society for Burn Injuries |
| Volume | 41 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - May 2015 |
| Externally published | Yes |
Keywords
- Burn
- Critical illness
- Deficit
- Energy
- ICU
- Intensive care
- International nutrition survey
- Nutrition
- Protein
Cite this
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International observational study of nutritional support in mechanically ventilated patients following burn injury. / Czapran, Adam; Headdon, William; Deane, Adam M.; Lange, Kylie; Chapman, Marianne J.; Heyland, Daren K.
In: Burns : Journal of the International Society for Burn Injuries, Vol. 41, No. 3, 05.2015, p. 510-518.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - International observational study of nutritional support in mechanically ventilated patients following burn injury
AU - Czapran, Adam
AU - Headdon, William
AU - Deane, Adam M.
AU - Lange, Kylie
AU - Chapman, Marianne J.
AU - Heyland, Daren K.
PY - 2015/5
Y1 - 2015/5
N2 - Introduction It has been proposed that nutritional therapy in critically ill patients after major burn reduces mortality. However, the actual practice of nutrient delivery, and the effect on outcome, has not been described. Study objectives To evaluate international practices related to nutritional support and outcomes in mechanically ventilated patients with burn injury. Methods Data from the International Nutrition Surveys (2007-2011) for patients with a primary diagnosis of burn were extracted and analysed. Results Eighty-eight of 90 patients (aged 16-84 years) received enteral nutrition. The median time for initiation of enteral feeding was 17 h [range 0-65]. Fifty patients (57%) had interruptions to nutrient delivery, most often these interruptions were fasting for operative procedures. There were substantive energy and protein deficits [943 (654) kcal/day and 49 (41) g/day, respectively; mean (SD)]. Nineteen (21%) patients died within 60 days of admission, and the energy and protein deficits were greater in those that died compared with survivors [died vs. survived, energy: 1251 (742) vs. 861 (607) kcal/d; p = 0.02; and protein 67(42) vs. 44(39) g/d; p = 0.03]. Energy and protein deficits were associated with increased mortality with the greater the deficit, the stronger the association with death (odds ratio for death: energy deficit/100 kcal 1.10 (1.01, 1.19); p = 0.028 and protein/10 g 1.16 (1.01, 1.33); p = 0.037). Results were similar and remained significant after adjusting for severity of illness. Conclusions Mechanically ventilated patients following burn develop substantial energy and protein deficits, with lesser deficits observed in survivors.
AB - Introduction It has been proposed that nutritional therapy in critically ill patients after major burn reduces mortality. However, the actual practice of nutrient delivery, and the effect on outcome, has not been described. Study objectives To evaluate international practices related to nutritional support and outcomes in mechanically ventilated patients with burn injury. Methods Data from the International Nutrition Surveys (2007-2011) for patients with a primary diagnosis of burn were extracted and analysed. Results Eighty-eight of 90 patients (aged 16-84 years) received enteral nutrition. The median time for initiation of enteral feeding was 17 h [range 0-65]. Fifty patients (57%) had interruptions to nutrient delivery, most often these interruptions were fasting for operative procedures. There were substantive energy and protein deficits [943 (654) kcal/day and 49 (41) g/day, respectively; mean (SD)]. Nineteen (21%) patients died within 60 days of admission, and the energy and protein deficits were greater in those that died compared with survivors [died vs. survived, energy: 1251 (742) vs. 861 (607) kcal/d; p = 0.02; and protein 67(42) vs. 44(39) g/d; p = 0.03]. Energy and protein deficits were associated with increased mortality with the greater the deficit, the stronger the association with death (odds ratio for death: energy deficit/100 kcal 1.10 (1.01, 1.19); p = 0.028 and protein/10 g 1.16 (1.01, 1.33); p = 0.037). Results were similar and remained significant after adjusting for severity of illness. Conclusions Mechanically ventilated patients following burn develop substantial energy and protein deficits, with lesser deficits observed in survivors.
KW - Burn
KW - Critical illness
KW - Deficit
KW - Energy
KW - ICU
KW - Intensive care
KW - International nutrition survey
KW - Nutrition
KW - Protein
UR - http://www.scopus.com/inward/record.url?scp=84925650474&partnerID=8YFLogxK
U2 - 10.1016/j.burns.2014.09.013
DO - 10.1016/j.burns.2014.09.013
M3 - Article
C2 - 25445003
AN - SCOPUS:84925650474
VL - 41
SP - 510
EP - 518
JO - Burns : Journal of the International Society for Burn Injuries
JF - Burns : Journal of the International Society for Burn Injuries
SN - 0305-4179
IS - 3
ER -