This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Garrel, D. R. Articles by Pugeat, M. M. Search for Related Content PubMed PubMed Citation Articles by Garrel, D. R. Articles by Pugeat, M. M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Burns Dietary Fats Hazardous Substances DB HYDROCORTISONE Social Bookmarking                         What's this?

Improved Clinical Status and Length of Care With Low-Fat Nutrition Support in Burn Patients

Hôtel-Dieu Hospital, Burn Center, University of Montréal Medical School, Montréal, Québec, Canada

Mohammad Razi, MD

Hôtel-Dieu Hospital, Burn Center, University of Montréal Medical School, Montréal, Québec, Canada

François Larivière, MD

Hôtel-Dieu Hospital, Burn Center, University of Montréal Medical School, Montréal, Québec, Canada

Nathalte Jobin, MSc

Hôtel-Dieu Hospital, Burn Center, University of Montréal Medical School, Montréal, Québec, Canada

Nazem Naman, MD

Hôtel-Dieu Hospital, Burn Center, University of Montréal Medical School, Montréal, Québec, Canada

Agnes Emptoz-Bonneton, MD

Antiquaille Hospital, Endocrine Division, Claude Bernard University, Lyon, France

Michel M. Pugeat, MD

Antiquaille Hospital, Endocrine Division, Claude Bernard University, Lyon, France

Background: The optimal amount and type of fat in the nutrition support of burned patients have not been determined. The aim of this study was to test low-fat nutritional solutions, with or without fish oil, on protein metabolism, morbidity, and length of care in severely burned adults. Methods: In a prospective randomized clinical trial, 43 patients were assigned to one of the following groups: control (35% fat), low-fat solution (ie, 15% of total calories as fat), low-fat with fish oil, given for 30 days. Nitrogen balance, urinary 3-methylhistidine excretion, urinary cortisol, and clinical status were measured daily. Corticosteroid-binding globulin and total and free serum cortisol were measured every 3 days. Results: Compared with controls, patients on low-fat support had fewer case of pneumonia: 3/24 vs 7/13 (p = .02), better respiratory and nutrition status, and shorter time to healing: 1.2 vs 1.8 days/% burned area (p = 0.01). There was no difference in nitrogen balance between groups, and 3-methylhistidine excretion was higher and serum free cortisol was lower in low—fat—fed patients than in controls. There was no difference between the two low-fat groups in any of the parameters measured. Conclusions: These study showed that low-fat nutrition support decreases infectious morbidity and shortens length of stay in burn patients. Fish oil does not seem to add clinical benefit to low-fat solutions. In addition, this study provides the first evidence that nutrition intervention modulates cortisol-binding globulin and the concentration of free circulating cortisol after a severe stress. (Journal of Parenteral and Enteral Nutrition 19:482-491, 1995)

Journal of Parenteral and Enteral Nutrition, Vol. 19, No. 6, 482-491 (1995)
DOI: 10.1177/0148607195019006482


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. A. McClave, R. G. Martindale, V. W. Vanek, M. McCarthy, P. Roberts, B. Taylor, J. B. Ochoa, L. Napolitano, G. Cresci, the A.S.P.E.N. Board of Directors, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) JPEN J Parenter Enteral Nutr, May 1, 2009; 33(3): 277 - 316. [Full Text] [PDF]

				S. E. Wolf, B. A. Shields, and C. E. Wade Letter to the Editor JPEN J Parenter Enteral Nutr, January 1, 2009; 33(1): 111 - 111. [Full Text] [PDF]

				S. Chevalier, R. Gougeon, K. Nayar, and J. A Morais Frailty amplifies the effects of aging on protein metabolism: role of protein intake Am. J. Clinical Nutrition, September 1, 2003; 78(3): 422 - 429. [Abstract] [Full Text] [PDF]

				American Society for Parenteral and Enteral Nutrit Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients JPEN J Parenter Enteral Nutr, January 1, 2002; 26(1_suppl): 1SA - 138SA. [PDF]

				D. Frankenfield, J. S. Smith, and R. N. Cooney Response to Klein JPEN J Parenter Enteral Nutr, July 1, 1998; 22(4): 249 - 250. [PDF]

				D. A. De-Souza and L. J. Greene Pharmacological Nutrition After Burn Injury J. Nutr., May 1, 1998; 128(5): 797 - 803. [Abstract] [Full Text]

				D. C. Frankenfield, J S. Smith, and R. N. Cooney Accelerated Nitrogen Loss After Traumatic Injury Is Not Attenuated by Achievement of Energy Balance JPEN J Parenter Enteral Nutr, November 1, 1997; 21(6): 324 - 329. [Abstract] [PDF]

				S. Klein, J. Kinney, K. Jeejeebhoy, D. Alpers, M. Hellerstein, M. Murray, and P. Twomey Nutrition Support in Clinical Practice: Review of Published Data and Recommendations for Future Research Directions: Summary of a Conference Sponsored by the National Institutes of Health, American Society for Parenteral and Enteral Nutrition, and American Society for Clinical Nutrition JPEN J Parenter Enteral Nutr, May 1, 1997; 21(3): 133 - 156. [Abstract] [PDF]