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Differential Effects of Three Enteral Dietary Regimens on Selected Outcome Variables in Burn Patients
Michele M. Gottschlich, PH.D., R.D., C.N.S.D.
Shriners Burns Institute, Cincinnati, Ohio
Marilyn Jenkins, R.N., M.B.A.
Shriners Burns Institute, Cincinnati, Ohio
Glenn D. Warden, M.D.
Shriners Burns Institute, Cincinnati, Ohio, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
Theresa Baumer, D.T.R.
Shriners Burns Institute, Cincinnati, Ohio
Pamela Havens, D.T.R.
Shriners Burns Institute, Cincinnati, Ohio
Jean T. Snook, PH.D.
The Ohio State University, Columbus, Ohio
J. Wesley Alexander, M.D., Sc.D.
Shriners Burns Institute, Cincinnati, Ohio, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
A modular tube feeding recipe (MTF) was designed to meet the unique nutritional needs of burn patients, applying principles previously documented in our burned guinea pig model. MTF, a high-protein, low-fat, linoleic acid-restricted formulation is enriched with omega-3 fatty acids, arginine, cysteine, histidine, vitamin A, zinc, and ascorbic acid. Fifty patients, 3 to 76 years of age with burns ranging from 10 to 89% total body surface area were prospectively randomized into three groups which blindly compared MTF to two enteral regimens widely utilized in the nutritional support of burns. Age, percent total and third-degree burn, resting energy expenditure, and calorie and protein intake were similar in all groups. Data analysis demonstrated significant superiority of MTF in the reduction of wound infection (p < 0.03) and length of stay/percent burn (p < 0.02). MTF was also associated with a decreased incidence of diarrhea, improved glucose tolerance, lower serum triglycerides, reduced total number of infectious episodes and trends toward improved preservation of muscle mass, although statistical significance was not achieved. Seventy percent of deaths occurred in the group supported with an inherently large dose of fat and linoleic acid. Combining these observations, it is believed that MTF is effective in modulating an improved response to burn injury. (Journal of Parenteral and Enteral Nutrition 14:225-236, 1990)
Journal of Parenteral and Enteral Nutrition, Vol. 14, No. 3,
225-236 (1990)
DOI: 10.1177/0148607190014003225
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