Investigation of Early Enteral Feeding in Patients with Major Burns

Yim, Haejun; Kim, Dohern; Hur, Jun; Kim, Jonghyun; Yoon, Daekun; Kang, Heejoon; Chon, Seongeun; Park, Sunggil; Lee, Jaejung; Chun, Wook

Abstract

PURPOSE
Severe burns induce multiple derangements in normal homeostasis. In this conditions, the value of proper nutritional supports can not be overemphasized. The purpose of this study was to evaluate the nutritional, immunological, catabolic and clinical effects of early enteral support in major burn patients. METHODS: The subjects were 49 major burned adults admitted to the Hangang Sacred Heart Hospital between June 1, 2003 and August 31, 2003. The patients qualified for study participation if they were over 20 years of age, sustained burns in excess of a 35% total body surface area or a 25% full-thickness burn. The early feeding (EF) group started enteral feeding within 48 hours of injury, and the delayed feeding (DF) group started after 48 hours. Each patients received entreral feeing through a nasogastric tube. The calorifice requirements were calculated by a modified Long's formula. Enteral feeding was discontinued when the patients could voluntarily orally take at least 60~70 percent of their estimated calorific or protein needs. The serum prealbumin, transferrin and immunoglobulin (IgG, IgA and IgM) concentrations, total lymphocyte counts and cortisol were monitored as a nutritional, immunological and catabolic marker. The clinical outcomes of the two groups were compared. RESULTS: Several of the markers were in an arithmtically high state for the EF group, but these were not statistical significance. There were no significant differences in the clinical outcomes between the two groups. CONCLUSION: More active trials and many-sided studies will be needed to maximize the effect of early enteral nutritional support as a method to improve treatment for major burned patients.