Article Text

TO ASSESS THE EFFECTIVENESS OF EARLY NUTRITION IN CHILDREN WITH SEVERE BURN TRAUMA
  1. J Erpuleva1,
  2. A U Lekmanov2
  1. 1ICU, Children’s Hospital No 9, Moscow, Russia
  2. 2Scientific ICU, Institute of Pediatrics and Children’s Surgery, Departments of Medicine of Russia, Moscow, Russia

Abstract

Introduction Severe thermal injury causes hyper metabolism with catabolism, gastric erosion. The aim was to evaluate the effect of nutritional support in early post burn period using special biochemical markers (visceral proteins and acute phase reactants).

Methods 24 children with severe burn (total burn surface area (TBSA) 30 and more %) aged from 4 month to 12 years old were observed. Daily needs of main nutrients were determined by Curreri equation. Starting from the 1st day after burn shock were received TPN with partial EEN using hydrolyzed milk-protein-based formulae. Enteral feeding was administered into the stomach by nasogastric tube or by jejunostomy feeding tube. Concentrations of blood serum proteins: albumin (Alb), Transthyretin (TTR), transferrin (Tf) and acute phase reactants: orosomucoid (OROS), C-reactive protein (CRP), alpha-1-antitrypsin (alpha-1-AT) were measured and analyzed twice a week between 5-th and 21-th post-burn day.

Results Serum visceral proteins levels were low in all patients on the 1-th day after burn shock. Levels Alb., TTR, Tf. progressively increased within the normal range in patients after 2 weeks after thermal injury. In additional, OROS, CRP levels were decrease during 2 weeks of the study.

Conclusion Early nutritional support preventing the catabolic dominance of protein metabolism. The above mentioned nutrition formulae are well-absorbed without causing intestinal peristalsis as they contain neither ballast substances, nor lactose, and very little stimulate bile and juice secretions by patients with severe burn condition.

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