Article (Scientific journals)
Nutritional therapy among burn injured patients in the critical care setting: An international multicenter observational study on “best achievable” practices
Chourdakis, M.; Bouras, E.; Shields, B. A. et al.
2020In Clinical Nutrition
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Keywords :
ICU; Micronutrients; Mortality; Nutrition therapy
Abstract :
[en] Background & aims: Burn patients pose a number of clinical challenges for doctors and dietitians to achieve optimal nutrition practice. The objective of this study was to describe nutrition practices in burn center intensive care units (ICUs) compared to the most recent ESPEN and SCCM/ASPEN guidelines (hereafter referenced as “the Guidelines”) and highlight the variation in practice and what is “best achievable.” Methods: In 2014–15, we prospectively enrolled 283 mechanically ventilated patients who were admitted to one of 14 burn ICUs for at least 72 h. Data collected included information on the estimation of energy and protein requirements, their actual delivery as well as route and time of feeding, and administration of micronutrients. We describe site practices and data per patient-day. Results: Adherence to the Guidelines for the use of enteral nutrition (EN) over parenteral nutrition (PN) was 90.5% of patient-days (site range 79.2%–97.0%). However, adherence to the Guidelines for the measurement of energy requirements was 6.0% of patient-days (site range 0.0%–93.3%), supplementation with glutamine took place in 22.4% of patient-days (site range 0.0%–61.8%). Provision of 80% of energy requirements within 48–72 h was achieved in 35.3% of patients (site range 0.0%–80.0%), and provision of 80% of protein needs within 48–72 h was achieved in 34.3% of patients (site range 0.0%–80.0%). Average nutritional adequacy was 64.9 ± 40.0% for energy (best site: 80.2%, worst site: 42.0%) and 65.6 ± 42.1% for protein (best site: 87.3%, worst site: 43.6%). Conclusion: The present findings indicate that despite high adherence to providing EN over PN, there is still a large gap between many recommendations and clinical practice, and the achievement of nutrition goals for patients in burn centers is suboptimal. © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
Disciplines :
Anesthesia & intensive care
Author, co-author :
Chourdakis, M.;  School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
Bouras, E.;  School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
Shields, B. A.;  Department of Nutritional Medicine and Metabolism, Burn Unit, U.S. Army Institute of Surgical Research, Ft. Sam HoustonTX, United States
Stoppe, C.;  Department of Intensive Care Medicine, University Hospital, RWTH Aachen, Germany
Rousseau, Anne-Françoise  ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Heyland, D. K.;  Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada, Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
Language :
English
Title :
Nutritional therapy among burn injured patients in the critical care setting: An international multicenter observational study on “best achievable” practices
Publication date :
2020
Journal title :
Clinical Nutrition
ISSN :
0261-5614
eISSN :
1532-1983
Publisher :
Churchill Livingstone
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 31 July 2021

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