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Weight changes and patterns of weight measurements in hospitalized burn patients:a contemporary analysis

Burns & trauma 2018年第4期6卷 262-268页

作者： Denisse Mendez-Romero audra t clark Alana Christie Steven E Wolf Department of Surgery Division of BurnTraumaand Critical CareUniversity of Texas Southwestern Medical CenterE05514B5323 Harry Hines BlvdDallasTX 75390USA

Background:Severe burn is associated with significant changes in body weight due to resuscitation volumes, fluid shifts, a hypermetabolic state, prolonged bed rest, and caloric intake. Our goal was to quantify and describe trends in weight change in patients with burns of all severities under modern treatment conditions and to identify the time points at which these changes occur. Methods: An institutional review board-approved chart review was conducted of acute burn patients treated at an American Burn Association-verified regional burn center from February 2016 to November 2016. Patients were then divided into three groups based on percent of total burn surface area (%tBSA) burn:1–19%, 20–39%, and≥40%. Weight was expressed as percent change of weight from baseline. Regression analysis was conducted on percent weight changes for each tBSA group. Results:We identified 197 burn patients with a length of stay (LOS) of≥7 days. Of the study cohort, 149 had tBSA burn of 1–19%, 27 had tBSA burn of 20–39%, and 21 had tBSA burn of≥40%. All groups had a majority of White male, non-Hispanic patients with mean ages between 40 and 42 years. Burn patients with>20%tBSA burn had a median increase in weight above baseline of approximately 5 to 8%likely due to resuscitation fluids within the first week of hospitalization. Weight loss below baseline often did not exceed 10% and was more pronounced as LOS increased, mostly in patients with >20% tBSA burn. Whereas patients with 1–19% tBSA burn on average returned to baseline weight at last measurement, patients with 20–39% tBSA and ≥40%tBSA burn continued a decline in weight at 4 weeks (r2=0.57 and 0.55, respectively) on the same trajectory. Conclusions:Burn patients with>20%tBSA burn had an increase in weight above baseline of up to 8%, likely due to resuscitation fluids within the first week of hospitalization. Weight loss below baseline often did not exceed 10%and was more pronounced as LOS increased, mostly in patients with>20%tBS

关键词： Burn Weight Nutrition Metabolism Critical care

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Nutrition and metabolism in burn patients

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Burns & trauma 2017年第2期5卷 95-106页

作者： audra clark Jonathan Imran tarik Madni Steven E. Wolf University of texas Southwestern Medical Center 5323 Harry Hines Blvd.Dallas TX 75390 USA

Severe burn causes significant metabolic derangements that make nutritional support uniquely important and challenging for burned patients. Burn injury causes a persistent and prolonged hypermetabolic state and increased catabolism that results in increased muscle wasting and cachexia. Metabolic rates of burn patients can surpass twice normal, and failure to fulfill these energy requirements causes impaired wound healing, organ dysfunction,and susceptibility to infection. Adequate assessment and provision of nutritional needs is imperative to care for these patients. there is no consensus regarding the optimal timing, route, amount, and composition of nutritional support for burn patients, but most clinicians advocate for early enteral nutrition with highcarbohydrate *** support must be individualized, monitored, and adjusted throughout recovery. Further investigation is needed regarding optimal nutritional support and accurate nutritional endpoints and goals.

关键词： Burn Nutrition Metabolism Critical care

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