Windle E M
Department of Nutrition and Dietetics, Pinderfields General Hospital, Wakefield, UK.
J Hum Nutr Diet. 2008 Apr;21(2):165-73; quiz 174-6. doi: 10.1111/j.1365-277X.2008.00860.x.
Patients with major burn injury are among the most catabolic and nutritionally vulnerable of all hospital admissions. A considerable amount of dietetic intervention is often required. To date, UK practice has not been described in detail. This study aimed to identify nutritional interventions, resource use and associated costs for a typical patient admitted with major burns.
A 28-year-old male with 43.5% total body surface area flame injury was selected for study. Dietetic, medical and pharmacy records were reviewed for data regarding nutritional status, interventions and product use. Costs of dietetic staffing, nutrition support products, related ancillary items and hospital food provision were calculated.
The patient required 68 days of nutrition support, including 40 days of nasogastric tube feeding. Seventy per cent of bedside reviews resulted in dietetic intervention. Initiation of nutrition support, substrate use, and frequency of biochemical and weight monitoring were largely in compliance with practice guidelines. Overall cost of nutritional care for the inpatient episode was pound 1377.
Work is now required to assess current nutrition practices across different UK centres and for a range of burn severities, to establish a baseline from which resource and financial requirements can ultimately be developed.
重度烧伤患者是所有入院患者中分解代谢最旺盛且营养最易受损的群体之一。通常需要大量的饮食干预。迄今为止，英国的相关做法尚未得到详细描述。本研究旨在确定一名典型的重度烧伤入院患者的营养干预措施、资源使用情况及相关成本。
选取一名28岁、全身43.5%体表面积火焰烧伤的男性患者进行研究。查阅饮食、医疗和药房记录，获取有关营养状况、干预措施和产品使用的数据。计算饮食人员配备、营养支持产品、相关辅助物品及医院食品供应的成本。
该患者需要68天的营养支持，其中包括40天的鼻饲喂养。70%的床边评估导致了饮食干预。营养支持的启动、底物使用以及生化和体重监测的频率在很大程度上符合实践指南。该住院期间营养护理的总成本为1377英镑。
现在需要开展工作，评估英国不同中心针对一系列烧伤严重程度的当前营养实践，以建立一个最终可据此制定资源和资金需求的基线。
