[Clinical and biological monitoring of nutritional status in severe burns].
OBJECTIVE
Burn patients are subject to hypermetabolism and catabolic states. Aim was to evaluate our current practice in nutrition.


METHODS
Twenty-one severely burned patients were prospectively included during three months period. Body weight was measured at least two times in a week during all stay in burn ICU. Biological markers of inflammation (C-reactive protein, CRP) and nutrition (prealbumin) were performed weekly. Protocol included early nasogastric feeding, tolerated gastric stasis less than 250 mL at four hours nasogastric aspirations, caloric target value of 40 Kcal/kg per day and measurement of total daily calorie intakes.


RESULTS
Patient demographics showed a mean percent total body surface burn of 51.1+/-27 % (range 20-90), age of 38.7+/-13.1 years (range 18-67) and 57.3 % of smoke inhalation. All patients were ventilated and 19 patients survived. Length of stay was 75.7+/-47 days (range 22-184). Patients received only 58.9+/-10 % of calorie intakes recommended by French burn society. Loss of body mass was 15.2+/-9 kg (range 3-31) or 19.1+/-10 % of admission weight (range 5-37). Erosion of body mass was not correlated with burned surface (p=0.08), calorie intakes (p=0.26), smoke inhalation (p=0.46), lengths of stay (p=0.53), lengths of ventilation (p=0.08) or nutrition (p=0.12), days of antibiotic (p=0.72), number of dressing changes (p=0.6) or surgery (p=0.64). Biological parameters showed CRP decreasing and prealbumin improving values.


CONCLUSIONS
New strategies of nutrition are necessary to improve outcome and reduce body mass loss in burns.
Bargues
L
L
Centre de traitement des brûlés, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92141 Clamart, France. BARGOL@AOL.COM
Cottez-Gacia
S
S
Jault
P
P
Renard
C
C
Vest
P
P
D001835:Body Weight; D002056:Burns / Q000503:physiopathology* / Q000628:therapy; D002097:C-Reactive Protein / Q000032:analysis; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007362:Intensive Care Units; D007441:Intubation, Gastrointestinal; D008991:Monitoring, Physiologic; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
D011228:Prealbumin; D002097:C-Reactive Protein