Association between dietary fat content and outcomes in pediatric burn patients

Jong Lee, Gerd G. Gauglitz, David Herndon, Hal K. Hawkins, Stefanie C. Halder, Marc G. Jeschke

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The aim of the study was to compare a low fat/high-carbohydrate diet and a high-fat diet on clinical outcomes by a retrospective cohort study. Methods: Nine hundred forty-four children with burns ≥ 40% of their total body surface area (TBSA) were divided into two groups: patients receiving Vivonex T.E.N. (low-fat/high-carbohydrate diet; n = 518) and patients receiving milk (high-fat diet; n = 426). Patient demographics, caloric intake, length of hospital stay, and incidence of sepsis, mortality, hepatic steatosis, and organomegaly at autopsy were determined. Results: Demographics and caloric intake were similar in both groups. Patients receiving Vivonex T.E.N. had shorter (intensive care unit) ICU stays (Vivonex T.E.N.: 31 ± 2 d; milk: 47 ± 2 d; P < 0.01), shorter ICU stay per % TBSA burn (Vivonex T.E.N.: 0.51 ± 0.02 d/%; milk: 0.77 ± 0.03 d/%; P < 0.01), lower incidence of sepsis (Vivonex T.E.N.: 11%; milk: 20%; P < 0.01), and lived significantly longer until death than those receiving milk (Vivonex T.E.N.: 20 ± 3 d; milk: 10 ± 2 d; P < 0.01). There was no difference in overall mortality between the two groups (Vivonex T.E.N.:15% versus milk: 13%; P < 0.9). Autopsies revealed decreased hepatic steatosis and decreased enlargement of kidney and spleen in patients receiving Vivonex T.E.N. Conclusions: The period with a low-fat/high-carbohydrate diet was associated with lower LOS, decreased incidence of organomegaly, infection, and hepatic steatosis post-burn compared with the period when a high-fat diet was used. These associations indicate the benefit of high carbohydrate/low fat nutrition; however, the findings in these time periods can also be likely due to the multifactorial effects of advances in burn care. We believe that these results have some relevance because high fat is associated with poorer outcomes compared with low fat.

Original languageEnglish (US)
JournalJournal of Surgical Research
Volume166
Issue number1
DOIs
StatePublished - Mar 2011

Fingerprint

Dietary Fats
High Fat Diet
Milk
Pediatrics
Carbohydrates
Body Surface Area
Fats
Energy Intake
Burns
Autopsy
Liver
Length of Stay
Sepsis
Incidence
Demography
Mortality
Vivonex
Intensive Care Units
Cohort Studies
Spleen

Keywords

  • burns
  • children
  • free fatty acids
  • milk
  • nutrition
  • VLDL

ASJC Scopus subject areas

  • Surgery

Cite this

Association between dietary fat content and outcomes in pediatric burn patients. / Lee, Jong; Gauglitz, Gerd G.; Herndon, David; Hawkins, Hal K.; Halder, Stefanie C.; Jeschke, Marc G.

In: Journal of Surgical Research, Vol. 166, No. 1, 03.2011.

Research output: Contribution to journalArticle

Lee, Jong ; Gauglitz, Gerd G. ; Herndon, David ; Hawkins, Hal K. ; Halder, Stefanie C. ; Jeschke, Marc G. / Association between dietary fat content and outcomes in pediatric burn patients. In: Journal of Surgical Research. 2011 ; Vol. 166, No. 1.
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abstract = "Background: The aim of the study was to compare a low fat/high-carbohydrate diet and a high-fat diet on clinical outcomes by a retrospective cohort study. Methods: Nine hundred forty-four children with burns ≥ 40{\%} of their total body surface area (TBSA) were divided into two groups: patients receiving Vivonex T.E.N. (low-fat/high-carbohydrate diet; n = 518) and patients receiving milk (high-fat diet; n = 426). Patient demographics, caloric intake, length of hospital stay, and incidence of sepsis, mortality, hepatic steatosis, and organomegaly at autopsy were determined. Results: Demographics and caloric intake were similar in both groups. Patients receiving Vivonex T.E.N. had shorter (intensive care unit) ICU stays (Vivonex T.E.N.: 31 ± 2 d; milk: 47 ± 2 d; P < 0.01), shorter ICU stay per {\%} TBSA burn (Vivonex T.E.N.: 0.51 ± 0.02 d/{\%}; milk: 0.77 ± 0.03 d/{\%}; P < 0.01), lower incidence of sepsis (Vivonex T.E.N.: 11{\%}; milk: 20{\%}; P < 0.01), and lived significantly longer until death than those receiving milk (Vivonex T.E.N.: 20 ± 3 d; milk: 10 ± 2 d; P < 0.01). There was no difference in overall mortality between the two groups (Vivonex T.E.N.:15{\%} versus milk: 13{\%}; P < 0.9). Autopsies revealed decreased hepatic steatosis and decreased enlargement of kidney and spleen in patients receiving Vivonex T.E.N. Conclusions: The period with a low-fat/high-carbohydrate diet was associated with lower LOS, decreased incidence of organomegaly, infection, and hepatic steatosis post-burn compared with the period when a high-fat diet was used. These associations indicate the benefit of high carbohydrate/low fat nutrition; however, the findings in these time periods can also be likely due to the multifactorial effects of advances in burn care. We believe that these results have some relevance because high fat is associated with poorer outcomes compared with low fat.",
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