Department of Pediatrics, Kermanshah University of Medical Sciences, Mashhad, Khorasan, Iran.
Burns. 2010 Nov;36(7):1067-71. doi: 10.1016/j.burns.2009.12.005. Epub 2010 Apr 18.
Burns increase the metabolic demands of the body and can lead to severe weight loss and increased risk of death. Early enteral support is believed to improve gastrointestinal, immunological, nutritional and metabolic responses to critical injury; however, this premise is in need of further substantiation by definitive data. This research aimed to examine the effectiveness and safety of early enteral feeding in paediatric patients suffering from burns.
This clinical trial was carried out with a total number of 688 children with burns hospitalised in the Burn Department across a 2-year period (September 2002-September 2004). The subjects were randomised into two groups. A total of 322 patients received only intravenous resuscitation, in accordance with current treatment protocols, in the first 48 h and were considered as the late enteral nutrition group (LEN group); 366 patients were nourished early enteral nutrition group (EEN group), such that both groups received similar amounts of fluid in the first 48 h. Initiation of enteral nutrition commenced between 3 and 6 h following the burn. The patients were kept in the unit until they were discharged. Wound management did not vary between groups.
In our study, the mean age was 5±3 years in the LEN group and 5±3.5 years in the EEN group. Hot liquids were the most common cause of burns in both groups. The mean percentage of burn was reported as 20±13 in the LEN group and 22±15 in the EEN group. Mean duration of hospitalisation was 16.4±3.7 days in the LEN group and 12.6±1.3 in the EEN group for cured patients (P<0.05). A total of 40 patients (12%) in the LEN group and 31 patients (8.5%) in the EEN group expired (P<0.05).
Our research showed that EEN decreases duration of hospitalisation and mortality in children with burns.
研究早期肠内营养在小儿烧伤患者中的有效性和安全性。
这是一项在烧伤科住院的 688 例烧伤患儿中进行的临床试验，研究时间为 2 年（2002 年 9 月至 2004 年 9 月）。将患儿随机分为两组。322 例患者仅接受静脉复苏，按照目前的治疗方案，在第 48 小时内接受治疗，作为晚期肠内营养组（LEN 组）；366 例患者接受早期肠内营养组（EEN 组），两组在第 48 小时内接受相同量的液体。肠内营养于烧伤后 3 至 6 小时开始。患儿在病房接受治疗，直至出院。两组的伤口处理无差异。
LEN 组的平均年龄为 5±3 岁，EEN 组为 5±3.5 岁。热液是两组患儿烧伤的最常见原因。LEN 组报告的烧伤平均百分比为 20±13%，EEN 组为 22±15%。LEN 组治愈患者的平均住院时间为 16.4±3.7 天，EEN 组为 12.6±1.3 天（P<0.05）。LEN 组共有 40 例（12%）患者和 EEN 组 31 例（8.5%）患者死亡（P<0.05）。
EEN 可缩短小儿烧伤患者的住院时间，降低死亡率。
