title: Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: critically-ill burnt patient.
abstract: The response to severe burns is characterized by hypermetabolism (the most hypermetabolic existing model of aggression) and hypercatabolism, with a high degree of destruction of the skeletal musculature. Metabolic disorders are most evident in the first two weeks after the burn, although they can be prolonged in direct relation to the complications that these patients develop. Nutritional-metabolic support is an essential part of the treatment of these patients and should be started early, preferentially through the enteral route, with parenteral nutrition as complementary support. Exact calculation of calorie-protein requirements in these patients is difficult, even when indirect calorimetry is used, due to the high loss of proteins and CO2 through the skin. Specific pharmaconutrients are indicated, with a high dose of micronutrients. The use of drugs or medications with anabolic effects is also sometimes indicated.
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain. agdl@telefonica.net
authors.forename: A
authors.initials: A
authors.lastname: García de Lorenzo y Mateos
authors.forename: C
authors.initials: C
authors.lastname: Ortiz Leyba
authors.forename: S M
authors.initials: SM
authors.lastname: Sánchez
mesh_terms: D002056:Burns / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D032921:Consensus; D016638:Critical Illness / Q000628:therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000627:therapeutic use; D004041:Dietary Fats / Q000008:administration & dosage / Q000627:therapeutic use; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D004750:Enteral Nutrition; D006801:Humans; D008659:Metabolic Diseases / Q000209:etiology / Q000628:therapy; D018977:Micronutrients / Q000008:administration & dosage / Q000627:therapeutic use; D009751:Nutritional Requirements; D018529:Nutritional Support / Q000379:methods*; D010288:Parenteral Nutrition / Q000379:methods
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D018977:Micronutrients