Abstract
Traditionally, it has been taught that a period of ileus occurs after significant burn injury, thus clinicians avoided use of the gut as the primary mode of administering nutrients in patients with major burns. Several studies have suggested early aggressive enteral support may be beneficial. One hundred six patients with burns involving 40 ± 21% of the total body surface area were entered into a study where gastric feeding was begun within 6 hours from the onset of injury. Feedings were administered as boluses and consisted of an intact protein diet. Eighty-two percent of the patients absorbed at least part of their tube-fed diet on the day of injury and this reached 95% by hospital day 4. Vomiting was the most frequent complication, occurring in 16 of 106 patients. No patient developed stress gastritis/ulcers and H-2 blockers were not used. Among those patients who were unable to tolerate early enteral feeding, the mortality rate was significantly higher (38.5% us 9.3%, p < 0.004); these patients also had significantly larger burn size, (60 ± 26% us 35% ± 14%, p < 0.007). Early enteral support via the gastric route is safe and effective in most patients with major burns. More severely injured burn patients may require nasoduodenal tube placement.
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