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Burns as the Outlier in Early Enteral Nutrition in Critical Illness

  • Nutrition, Metabolism, and Surgery (Keith Miller, Section Editor)
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Abstract

Purpose of Review

Severe burn injuries result in a number of physiologic and metabolic derangements that make nutritional support an especially critical and challenging component of burn patient's treatment. This article aims to review the current literature regarding early enteral nutrition in burn patients.

Recent Findings

Early enteral feeding is thought to be an important component of modulating the hypermetabolic and inflammatory response seen in critical illness. This dogma has been questioned by studies indicating that permissive underfeeding in the first phase of critical illness might be of benefit. However, these studies lack stratification to evaluate outcomes in the burn population, specifically. Studies that do evaluate early enteral nutrition in the burn population have revealed reduced morbidity and mortality with this nutrition strategy.

Summary

The hypermetabolic response that occurs in severe burns makes this form of injury unique. Evidence supports early enteral nutrition as the gold standard in this population. Future advances in the field of nutrition must be evaluated in the burn population, specifically, before being applied to patients with this form of critical illness.

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Fig. 1

Adapted from Refs. [3, 14,15,16,17]

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Papers of particular interest, published recently, have been highlighted as: ∙ Of importance

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  1. Elizabeth H. Bruenderman and Justin J. Webb have contributed equally to this manuscript.

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  1. Division of Trauma and Critical Care, Department of Surgery, University of Louisville, 550 South Jackson Street, 2nd Floor, Louisville, KY, 40202, USA

    Elizabeth H. Bruenderman, Justin J. Webb & Matthew C. Bozeman

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  1. Elizabeth H. Bruenderman
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Bruenderman, E.H., Webb, J.J. & Bozeman, M.C. Burns as the Outlier in Early Enteral Nutrition in Critical Illness. Curr Surg Rep 8, 1 (2020). https://doi.org/10.1007/s40137-019-0246-9

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