Increased mortality with intravenous supplemental feeding in severely burned patients

David Herndon, R. E. Barrow, M. Stein, H. Linares, T. C. Rutan, R. Rutan, S. Abston

Research output: Contribution to journalArticle

180 Citations (Scopus)

Abstract

Patients with large cutaneous burns are characterized by an elevated metabolic rate and lose up to 25% of their body weight within 3 weeks. A previous study suggested that intravenous supplementation to attain nutritional requirements was of no benefit in patients with cutaneous burns covering >50% of their total body surface area. In this study 39 patients with burns >50% of their total body surface area were randomly assigned to receive intravenous supplementation of enteral calories (n = 16) or enteral calories alone (n = 23). Intravenous supplementation decreased the amount of enteral calories that patients with burns could tolerate. The mortality rate was significantly higher (p < 0.05) in the intravenously supplemented group at 63% as compared with 26% in the group receiving enteral calories alone. Both groups showed significant decrease in natural killer cell activity when compared with controls at both 0 to 7 and 7 to 14 days after injury. T cell helper/suppressor ratios were depressed in both groups when compared with controls; however, the intravenously supplemented group was significantly depressed at 7 to 14 days after burn. Both groups demonstrated hepatomegaly, moderate fatty infiltration, and cholestasis. It is suggested that intravenous supplementation should be carefully evaluated and used only in patients with total enteral failure.

Original languageEnglish (US)
Pages (from-to)309-313
Number of pages5
JournalJournal of Burn Care and Rehabilitation
Volume10
Issue number4
StatePublished - 1989

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Parenteral Nutrition
Small Intestine
Burns
Mortality
Body Surface Area
Nutritional Requirements
Skin
Hepatomegaly
Cholestasis
Helper-Inducer T-Lymphocytes
Natural Killer Cells
Body Weight
Wounds and Injuries

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery
  • Nursing(all)
  • Health Professions(all)

Cite this

Herndon, D., Barrow, R. E., Stein, M., Linares, H., Rutan, T. C., Rutan, R., & Abston, S. (1989). Increased mortality with intravenous supplemental feeding in severely burned patients. Journal of Burn Care and Rehabilitation, 10(4), 309-313.

Increased mortality with intravenous supplemental feeding in severely burned patients. / Herndon, David; Barrow, R. E.; Stein, M.; Linares, H.; Rutan, T. C.; Rutan, R.; Abston, S.

In: Journal of Burn Care and Rehabilitation, Vol. 10, No. 4, 1989, p. 309-313.

Research output: Contribution to journalArticle

Herndon, D, Barrow, RE, Stein, M, Linares, H, Rutan, TC, Rutan, R & Abston, S 1989, 'Increased mortality with intravenous supplemental feeding in severely burned patients', Journal of Burn Care and Rehabilitation, vol. 10, no. 4, pp. 309-313.
Herndon D, Barrow RE, Stein M, Linares H, Rutan TC, Rutan R et al. Increased mortality with intravenous supplemental feeding in severely burned patients. Journal of Burn Care and Rehabilitation. 1989;10(4):309-313.
Herndon, David ; Barrow, R. E. ; Stein, M. ; Linares, H. ; Rutan, T. C. ; Rutan, R. ; Abston, S. / Increased mortality with intravenous supplemental feeding in severely burned patients. In: Journal of Burn Care and Rehabilitation. 1989 ; Vol. 10, No. 4. pp. 309-313.
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