期刊
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
卷 54, 期 4, 页码 755-761出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.TA.0000060260.61478.A7
关键词
enteral feeding; severe burns; hypermetabolism
资金
- NCRR NIH HHS [M01-RR00073] Funding Source: Medline
- NIGMS NIH HHS [2T32GM0825611, 1P50GM60338-01, GM-56687-02] Funding Source: Medline
Background: Severe burn induces a systemic hypermetabolic response, which includes increased energy expenditure, protein catabolism, and diminished immunity. We hypothesized that early burn excision and aggressive enteral feeding diminish hypermetabolism. Methods: Forty-six burned children were enrolled into a cohort analytic study. Cohorts were segregated according to time from burn to transfer to our institution for excision, grafting, and nutritional support. No subject had undergone wound excision or continuous nutritional support before transfer. Resting energy expenditure, skeletal muscle protein kinetics, the degree of bacterial colonization from quantitative cultures, and the incidence of burn sepsis were measured as outcome variables. Results: Early, aggressive treatment did not decrease energy expenditure; however, it did markedly attenuate muscle protein catabolism when compared with delay in aggressive treatment. Wound colonization and sepsis were diminished in the early treatment group as well. Conclusion: Early excision and concurrent aggressive feeding attenuate muscle catabolism and improve infectious outcomes after burn.
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