Background: Burned patients have increased level of mortality, possibly due to late introduction of enteral feeding. The aim of this study was to compare the benefits and safety of very early enteral nutrition introduction compared to the normal diet among burns patients in an intensive care unit.
Participants and methods: Participants consisted of 101 patients, aged 20-76 years (mean age 48 years), 49 men and 52 women, with burns that covered more than 20% of the body. The intervention group consisted of 52 subjects fed via introduced nasojejunal probe that started within four hours after admission to the hospital. The control group consisted of fifty patients fed in standard manner per os (three standard hospital meals) immediately after the first wound dressing.
Results: The average decline BMI in control group was 2.27±0.56 kg/m2, while the average reduction in BMI in the intervention group was 1.77±0.38 kg/m2 (p<0.001). The largest drop of albumin concentration in the control group was 28.5%, whereas in the intervention group was 23.8%. (p<0.001). The greatest decrease of transferrin concentration in the control group was 31.1%, while the average reduction in the intervention group was 18.3%. (p<0.001). C-reactive protein values were statistically higher in control group (p<0.001). Intervention group had lower rate of complications and infection rates.
Conclusion: Enteral nutrition in burned patients should begin within few hours of burn onset. Such approach leads to better outcomes, reduces complications, and improves nutritional profile.
背景：燒傷病人死亡風險的增加，可能是因為腸道進食較晚開始。本研究目的 為比較加護病房的燒傷病人，在很早期採用腸道營養比起常規飲食者的益處及 安全性。參與者與方法：參與者為101 名年齡20-76 歲(平均年齡48 歲)的病 人，有49 名男性和52 名女性，其身體燒傷面積都超過20%。介入組有52 名，在入院後的四小時內透過鼻空腸導管餵食。控制組有50 名病人，在第一 次換藥後立即以標準程序經口進食(三餐標準醫院餐點)。結果：控制組平均 BMI 下降2.270.56 kg/m2，而介入組平均減少1.770.38 kg/m2 (p<0.001)。控 制組的白蛋白濃度最大跌幅為28.5%，但在介入組為23.8% (p<0.001)。控制組 的運鐵蛋白濃度最大降幅為31.1%，而介入組則平均下降18.3% (p<0.001)。控 制組的C-反應蛋白高於介入組，並達統計顯著性(p<0.001)。介入組有較低的 併發症及感染率。總結：腸道營養應該開始於燒傷發生後數小時內。該項做法 可導致較好的預後、降低併發症及改善營養狀況。