Adult Burns Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
Nutr Diet. 2022 Nov;79(5):582-589. doi: 10.1111/1747-0080.12746. Epub 2022 Jun 28.
Early enteral nutrition (provided within 24 h of admission) is the optimal form of nutritional support for major burn injuries. The aim of this study was to (i) audit early enteral nutrition practices, (ii) identify characteristics of patients who received early enteral nutrition, and (iii) investigate whether early enteral nutrition was associated with in-hospital outcomes.
An analysis of prospectively collected data from the Burns Registry of Australia and New Zealand was conducted. Specifically, this study focused on major burns patients (defined as burns affecting more than 20% and 15% total body surface area for adult paediatric patients, respectively) admitted to a specialist burn service between 1 July 2016 and 30 June 2019.
Data from 474 major burns patients (88 paediatric patients) revealed 69% received early enteral nutrition. Paediatric patients who received early enteral nutrition were younger than their counterparts who did not receive the same support (p = 0.04). Adult patients who received early enteral nutrition sustained larger burns (p < 0.001). Early enteral nutrition was not associated with in-hospital mortality following major burn injury in adult patients in either unadjusted (p = 0.77) or confounder-adjusted (p = 0.69) analyses.
Approximately two-thirds of patients with major burn injuries received early enteral nutrition. Early enteral nutrition was not associated with in-hospital mortality following major burn injury. Further research should focus on modifiable reasons why major burns patients do not receive enteral nutrition within 24 h of admission.
早期肠内营养（在入院后 24 小时内提供）是严重烧伤患者最佳的营养支持形式。本研究旨在：（i）审查早期肠内营养实践，（ii）确定接受早期肠内营养的患者特征，以及（iii）调查早期肠内营养是否与院内结局相关。
对澳大利亚和新西兰烧伤登记处前瞻性收集的数据进行了分析。具体来说，本研究集中于严重烧伤患者（定义为成人和儿科患者的烧伤面积分别超过 20%和 15%的体表面积），这些患者于 2016 年 7 月 1 日至 2019 年 6 月 30 日期间入住专科烧伤服务机构。
474 名严重烧伤患者（88 名儿科患者）的数据显示，69%的患者接受了早期肠内营养。接受早期肠内营养的儿科患者比未接受相同支持的患者年龄更小（p=0.04）。接受早期肠内营养的成年患者的烧伤面积更大（p<0.001）。在未调整（p=0.77）或混杂因素调整（p=0.69）分析中，成人严重烧伤患者接受早期肠内营养与院内死亡率均无关。
大约三分之二的严重烧伤患者接受了早期肠内营养。严重烧伤患者在入院后 24 小时内未接受肠内营养与院内死亡率无关。进一步的研究应集中于为什么严重烧伤患者未能在入院后 24 小时内接受肠内营养的可改变原因。
