title: Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding.
abstract: This study was performed to investigate the mechanism whereby immediate enteral feeding after burn injury reduces postburn hypermetabolism and hypercatabolism. Fifty-seven burned guinea pigs (30% TBSA) were divided into three groups: A (N = 19), given 175 kcal/kg/day beginning 2 hours after burn; B (N = 20), given 175 kcal/kg/day with an initial 72-hour adaptation period; and C (N = 18), given 200 kcal/kg/day with the same adaptation period as B. Resting metabolic expenditure (RME) on PBD 13 was lowest in group A (109% of preburn level), compared with group B (144%, p less than 0.001) and group C (137%, p less than 0.01). On PBD 1, group A had the greatest jejunal mucosal weight and thickness (p less than 0.001), and mucosal weight had negative correlations with plasma cortisol (r = 0.829, p less than 0.001) and glucagon (r = 0.888, p less than 0.001). Two weeks after burn, urinary vanillyl mandelic acid (VMA) excretion, plasma cortisol, and glucagon were lowest in group A (p less than 0.05 to p less than 0.01). These hormones also significantly correlated with RME (p less than 0.01 to p less than 0.001). These findings suggest that immediate postburn enteral feeding can prevent hypermetabolism via preservation of gut mucosal integrity and prevention of excessive secretion of catabolic hormones.
mesh_terms: D000818:Animals; D001835:Body Weight; D002056:Burns / Q000378:metabolism*; D003176:Complement C3 / Q000032:analysis; D002149:Energy Intake; D004734:Energy Metabolism; D004750:Enteral Nutrition; D005260:Female; D005934:Glucagon / Q000032:analysis; D006168:Guinea Pigs; D006854:Hydrocortisone / Q000032:analysis; D007413:Intestinal Mucosa / Q000473:pathology; D008099:Liver / Q000378:metabolism; D008659:Metabolic Diseases / Q000517:prevention & control*; D009132:Muscles / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D009929:Organ Size; D014168:Transferrin / Q000097:blood; D014642:Vanilmandelic Acid / Q000652:urine
chemical_list: D003176:Complement C3; D014168:Transferrin; D014642:Vanilmandelic Acid; D005934:Glucagon; D009584:Nitrogen; D006854:Hydrocortisone