Compliance with nutrition support guidelines in acutely burned patients

Burns, 06/08/2012

Holt B et al. – The median time for initiation of enteral nutrition was within the Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient.

Methods

  • Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review.
  • Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay.
  • Descriptive statistics were used for all analyses.
  • IRB approval was obtained.

Results

  • Thirty-seven patients were included in this retrospective review.
  • Median age of patients was 44.9 years (IQR: 24.2–55.1), and median burn injury size was 30% (IQR: 19–47).
  • Median time to feeding tube placement was 31.1h post admission (IQR: 23.6–50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4–59.9h).
  • The median time required for patients to reach 60% of caloric goal was 3days post-admission (IQR: 3–4.5).

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