Effects of early excision and aggressive enteral feeding on hypermetabolism, catabolism, and sepsis after severe burn

David W. Hart, Steven E. Wolf, David L. Chinkes, Robert B. Beauford, Ronald P. Mlcak, John P. Heggers, Robert R. Wolfe, David N. Herndon

Research output: Contribution to journalArticle

126 Scopus citations

Abstract

Background Severe burn induces a systemic hypermetabolic response, which includes increased energy expenditure, protein catabolism, and diminished immunity. We hypothesized that early burn excision and aggressive enteral feeding diminish hypermetabolism. Methods Forty-six burned children were enrolled into a cohort analytic study. Cohorts were segregated according to time from burn to transfer to our institution for excision, grafting, and nutritional support. No subject had undergone wound excision or continuous nutritional support before transfer. Resting energy expenditure, skeletal muscle protein kinetics, the degree of bacterial colonization from quantitative cultures, and the incidence of burn sepsis were measured as outcome variables. Results Early, aggressive treatment did not decrease energy expenditure; however, it did markedly attenuate muscle protein catabolism when compared with delay in aggressive treatment. Wound colonization and sepsis were diminished in the early treatment group as well. Conclusion Early excision and concurrent aggressive feeding attenuate muscle catabolism and improve infectious outcomes after burn.

Original languageEnglish (US)
Pages (from-to)755-764
Number of pages10
JournalJournal of Trauma
Volume54
Issue number4
DOIs
StatePublished - Apr 2003

Keywords

  • Enteral feeding
  • Hypermetabolism
  • Severe burns

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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    Hart, D. W., Wolf, S. E., Chinkes, D. L., Beauford, R. B., Mlcak, R. P., Heggers, J. P., Wolfe, R. R., & Herndon, D. N. (2003). Effects of early excision and aggressive enteral feeding on hypermetabolism, catabolism, and sepsis after severe burn. Journal of Trauma, 54(4), 755-764. https://doi.org/10.1097/01.TA.0000060260.61478.A7