ORIGINAL PAPER
Evaluation of nutritional therapy in paediatric burn injuries
Submission date: 2018-12-30
Final revision date: 2019-01-23
Acceptance date: 2019-02-08
Publication date: 2019-02-27
Pediatr Pol 2019;94(1):1-5
KEYWORDS
TOPICS
ABSTRACT
Aim of the study:
Burn injuries occur mainly in children, primarily between two and four years of age. The most common cause of burns is contact with hot liquid. Apart from local treatment of damaged tissues, an important role in burn injury management is played by immediate implementation of burn disease management. This procedure, aimed at mitigation of systemic effects of thermal injury, consists of an adequate nutritional procedure, including supply of high-protein diet. The purpose of this study is to evaluate the nutritional procedure in children with burns.
Material and methods:
An evaluation was performed on nutritional interventions implemented in children hospitalised for burn injuries in 2010–2017. The effectiveness of the use of oral nutritional supplements was researched in detail.
Results:
In the studied period, 310 children were hospitalised for burns. Implementation of temporary parenteral nutrition was necessary in 1.94% of patients. In the subsequent years of the study, a significant increase in the supply of oral nutritional supplements (ONS) within the nutritional intervention was observed (2.6% vs. 45.7%). The applied nutritional interventions enabled maintenance of a proper nutritional status during treatment at the surgery department. The values of total protein and albumins as of the last day of hospitalisation displayed no significant differences compared to the values determined at admission to hospital. Paediatric patients administered with ONS had significantly higher total protein values at discharge from hospital (6.87 ±0.12 g/dl for ONS vs. 6.26 ±0.24 g/dl for N-ONS) and displayed a higher rate of burn wound healing (p = 0.030).
Conclusions:
Implementation of adequate nutritional intervention affects both the course of burn disease management and the wound healing rate. Oral nutritional supplements play an increasing role in the treatment of paediatric patients with burn injuries. Administration of ONS has a significant impact on the nutritional status of burnt children and accelerates the wound healing process.
Burn injuries occur mainly in children, primarily between two and four years of age. The most common cause of burns is contact with hot liquid. Apart from local treatment of damaged tissues, an important role in burn injury management is played by immediate implementation of burn disease management. This procedure, aimed at mitigation of systemic effects of thermal injury, consists of an adequate nutritional procedure, including supply of high-protein diet. The purpose of this study is to evaluate the nutritional procedure in children with burns.
Material and methods:
An evaluation was performed on nutritional interventions implemented in children hospitalised for burn injuries in 2010–2017. The effectiveness of the use of oral nutritional supplements was researched in detail.
Results:
In the studied period, 310 children were hospitalised for burns. Implementation of temporary parenteral nutrition was necessary in 1.94% of patients. In the subsequent years of the study, a significant increase in the supply of oral nutritional supplements (ONS) within the nutritional intervention was observed (2.6% vs. 45.7%). The applied nutritional interventions enabled maintenance of a proper nutritional status during treatment at the surgery department. The values of total protein and albumins as of the last day of hospitalisation displayed no significant differences compared to the values determined at admission to hospital. Paediatric patients administered with ONS had significantly higher total protein values at discharge from hospital (6.87 ±0.12 g/dl for ONS vs. 6.26 ±0.24 g/dl for N-ONS) and displayed a higher rate of burn wound healing (p = 0.030).
Conclusions:
Implementation of adequate nutritional intervention affects both the course of burn disease management and the wound healing rate. Oral nutritional supplements play an increasing role in the treatment of paediatric patients with burn injuries. Administration of ONS has a significant impact on the nutritional status of burnt children and accelerates the wound healing process.
REFERENCES (12)
1.
Coss-Bu J, Hamilton-Reeves J, Patel J, et al. Protein requirements of the critically ill pediatric patient. Nutr Clin Pract 2017; 32 (1 Suppl): 128S-141S.
2.
LeCompte MT, Rae L, Kahn SA. A survey of the use of propranolol in burn centers: Who, what, when, why. Burns 2017; 43: 121-126.
3.
Rousseau AF, Losser MR, Ichai C, Berger MM. ESPEN endorsed recommendations: nutritional therapy in major burns. Clin Nutr 2013; 32: 497-502.
4.
Vijfhuize S, Verburg M, Marino L, et al. An evaluation of nutritional practice in a paediatric burns unit. S Afr Med J 2010; 100: 383-386.
5.
Williams GJ, Herndon DN. Modulating the hypermetabolic response to burn injuries. J Wound Care 2002; 11: 87-89.
6.
Chan MM, Chan GM. Nutritional therapy for burns in children and adults. Nutrition 2009; 25: 261-269.
7.
Khorasani EN, Mansouri F. Effect of early enteral nutrition on morbidity and mortality in children with burns. Burns 2017; 36: 1067-1071.
8.
Dylewski ML, Baker M, Prelack K, et al. The safety and efficacy of parenteral nutrition among pediatric patients with burn injuries. Pediatr Crit Care Med 2013; 14: 120-125.
9.
Kreis BE, Middelkoop E, Vloemans AF, Kreis RW. The use of a PEG tube in a burn centre. Burns 2002; 28: 191-197.
10.
Suri MP, Dhingra VJ, Raibagkar, SC, Mehta DR. Nutrition in burns: need for an aggressive dynamic approach. Burns 2006; 32: 880-884.
11.
Chao T, Herndon DN, Porter C, et al. Skeletal muscle protein breakdown remains elevated in pediatric burn survivors up to one-year post-injury. Shock 2015; 44: 397-401.
12.
Gottschlich MM, Mayes T, Khoury J, Kagan RJ. Clinical trial of vitamin D2 vs D3 supplementation in critically ill pediatric burn patients. J Parenter Enteral Nutr 2017; 41: 412-421.
Share
RELATED ARTICLE
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
