ESPEN endorsed recommendations: nutritional therapy in major burns.

Details

Serval ID
serval:BIB_0FF982C2ADDC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
ESPEN endorsed recommendations: nutritional therapy in major burns.
Journal
Clinical Nutrition
Author(s)
Rousseau A.F., Losser M.R., Ichai C., Berger M.M.
ISSN
1532-1983 (Electronic)
ISSN-L
0261-5614
Publication state
Published
Issued date
2013
Volume
32
Number
4
Pages
497-502
Language
english
Notes
Publication types: Journal Article Correction dans Volume: 32 Issue: 5 Pages: 877-877 DOI: 10.1016/j.clnu.2013.07.006 The authors regret that the printed version of the above article contained an important typographical error on page 500 (Section 3.6): A "0." was added before the dose of "66 mg/kg/h", erroneously reducing the treatment dose by a factor 100 (original dose in Tanaka et al., Arch Surg, 2000). The authors would like to apologise for any inconvenience caused.
Abstract
BACKGROUND & AIMS: Nutrition therapy is a cornerstone of burn care from the early resuscitation phase until the end of rehabilitation. While several aspects of nutrition therapy are similar in major burns and other critical care conditions, the patho-physiology of burn injury with its major endocrine, inflammatory, metabolic and immune alterations requires some specific nutritional interventions. The present text developed by the French speaking societies, is updated to provide evidenced-based recommendations for clinical practice.
METHODS: A group of burn specialists used the GRADE methodology (Grade of Recommendation, Assessment, Development and Evaluation) to evaluate human burn clinical trials between 1979 and 2011. The resulting recommendations, strong suggestions or suggestions were then rated by the non-burn specialized experts according to their agreement (strong, moderate or weak).
RESULTS: Eight major recommendations were made. Strong recommendations were made regarding, 1) early enteral feeding, 2) the elevated protein requirements (1.5-2 g/kg in adults, 3 g/kg in children), 3) the limitation of glucose delivery to a maximum of 55% of energy and 5 mg/kg/h associated with moderate blood glucose (target ≤ 8 mmol/l) control by means of continuous infusion, 4) to associated trace element and vitamin substitution early on, and 5) to use non-nutritional strategies to attenuate hypermetabolism by pharmacological (propranolol, oxandrolone) and physical tools (early surgery and thermo-neutral room) during the first weeks after injury. Suggestion were made in absence of indirect calorimetry, to use of the Toronto equation (Schoffield in children) for energy requirement determination (risk of overfeeding), and to maintain fat administration ≤ 30% of total energy delivery.
CONCLUSION: The nutritional therapy in major burns has evidence-based specificities that contribute to improve clinical outcome.
Pubmed
Web of science
Create date
11/08/2013 8:21
Last modification date
20/08/2019 12:36
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