Titre
Impact of decreasing energy intakes in major burn patients: A 15-year retrospective cohort study.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Pantet, O.
Auteure/Auteur
Stoecklin, P.
Auteure/Auteur
Vernay, A.
Auteure/Auteur
Berger, M.M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1532-1983
Statut éditorial
Publié
Date de publication
2017-06
Volume
36
Numéro
3
Première page
818
Dernière page/numéro d’article
824
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Nutritional therapy is particularly important after major burn injury and specific nutritional guidelines have been developed. The study aimed at evaluating the impact of the changes in our nutritional practice, general compliance with the guidelines and potential consequences.
Retrospective analysis of prospectively collected data in burn patients requiring intensive care (ICU) between 1999 and 2014.
admission on day 1, full treatment and length of ICU stay >7 days. Four periods (P) were defined by protocol changes (P1: 1999-2001, P2: 2002-2005, P3: 2006-2010, P4: 2011-2014). Collected data: demographic and nutritional data, infectious complications, weights, CRP and prealbumin concentrations during the first 21 days.
240 patients were included (median age 43 years, burned area 25%). Measured energy expenditure (MEE) was stable through all periods but the prescribed caloric target decreased significantly, and below MEE (P1: 33 kcal/kg, IQR 7, P4: 28 kcal/kg, IQR 8, p < 0.001). Energy delivery ended decreasing below 30 kcal/kg/day (P1: 30 kcal/kg, IQR 23, P4: 25 kcal/kg, IQR 12, p < 0.001). Protein intakes increased due the use of high protein solutions and glutamine (P1: 1.04 g/kg, IQR 0.90, P4: 1.26, IQR 0.99, p < 0.001). Weight loss by day 21 increased significantly according to area under the curve (P1: 701, IQR 38, P2: 722, IQR 51, P4: 689 IQR 63, p = 0.02). Prealbumin levels decreased with energy decrease (P1: 150 mg/L, IQR 110, P4: 80 mg/L, IQR 70, p = 0.003).
The observed reduction of the energy delivery <30 kcal/kg was associated with a supplemental weight loss and lower prealbumin concentrations.
Retrospective analysis of prospectively collected data in burn patients requiring intensive care (ICU) between 1999 and 2014.
admission on day 1, full treatment and length of ICU stay >7 days. Four periods (P) were defined by protocol changes (P1: 1999-2001, P2: 2002-2005, P3: 2006-2010, P4: 2011-2014). Collected data: demographic and nutritional data, infectious complications, weights, CRP and prealbumin concentrations during the first 21 days.
240 patients were included (median age 43 years, burned area 25%). Measured energy expenditure (MEE) was stable through all periods but the prescribed caloric target decreased significantly, and below MEE (P1: 33 kcal/kg, IQR 7, P4: 28 kcal/kg, IQR 8, p < 0.001). Energy delivery ended decreasing below 30 kcal/kg/day (P1: 30 kcal/kg, IQR 23, P4: 25 kcal/kg, IQR 12, p < 0.001). Protein intakes increased due the use of high protein solutions and glutamine (P1: 1.04 g/kg, IQR 0.90, P4: 1.26, IQR 0.99, p < 0.001). Weight loss by day 21 increased significantly according to area under the curve (P1: 701, IQR 38, P2: 722, IQR 51, P4: 689 IQR 63, p = 0.02). Prealbumin levels decreased with energy decrease (P1: 150 mg/L, IQR 110, P4: 80 mg/L, IQR 70, p = 0.003).
The observed reduction of the energy delivery <30 kcal/kg was associated with a supplemental weight loss and lower prealbumin concentrations.
Sujets
PID Serval
serval:BIB_67656307E1B1
PMID
Date de création
2016-06-14T16:14:17.593Z
Date de création dans IRIS
2025-05-20T23:59:00Z