Early enteral feeding for burned patients—An effective method which should be encouraged in developing countries

Lam, N N; Tien, Nguyen Gia; Khoa, Chu Manh

doi:10.1016/j.burns.2007.03.010

Cited by 57 publications

(30 citation statements)

References 8 publications

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“…1,2 In patients with severe burns, those who received enteral feedings had lower complication and mortality rates than did those who received parenteral feedings. 3 The challenge of enteral feedings in the burn intensive care unit (ICU) has not been related to the placement and use of enteral tubes but rather the method of securement to prevent inadvertent dislodgments. on nasal tubes of 3 different critically ill burn patients.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of nasal bridling to secure enteral tubes in burn patients

Parks¹,

Klaus

Staggs

et al. 2013

American Journal of Critical Care

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Background Reliable securement of nasally inserted enteral tubes is a problem in patients with facial burns that make use of traditional adhesive tape ineffective. Objective To implement the nasal bridle as a way to decrease inadvertent removal of nasally inserted enteral tubes and improve subsequent patient outcomes. Methods The nasal bridle was implemented in the burn unit of the University of Kansas Hospital, Kansas City, Kansas, as a quality improvement project. Outcomes for the calendar year 2010 were measured in patients treated before use of the bridle (prebridle control group) and in patients for whom the bridle was used. The groups were compared on measures of tube insertions per tube day, abdominal radiographs per tube day, and a number of complications. Results A total of 50 patients were studied: 33 in the control group and 17 in the bridle group. Baseline characteristics of age and sex did not differ between the groups. The bridle group had significantly fewer tube insertions and abdominal radiographs per tube day than the control group. Although complications were generally less common in the bridle group, the differences were not statistically significant. Conclusions In burn patients, use of a nasal bridle to secure nasally inserted tubes had clinical advantages over securement with traditional adhesive tape. (American Journal of Critical Care. 2013;22:136–142)

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Section: Introductionmentioning

confidence: 99%

Outcomes of nasal bridling to secure enteral tubes in burn patients

Parks¹,

Klaus

Staggs

et al. 2013

American Journal of Critical Care

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“…Lam et al concluded that, in burns patients, early enteral nutrition had better effects than total parenteral nutrition on immune and metabolic function and reduces the rates of complications and mortality 13. Cumulative DDDs of all enteral nutrition formulas in the burns ward accounted for 10.5% of the sum of DDDs for all enteral nutrition formulas in all wards, reflecting good awareness of the need for enteral nutrition support in burns patients.…”

Section: Discussionmentioning

confidence: 99%

Prescribing practice and evaluation of appropriateness of enteral nutrition in a university teaching hospital

Xiao¹,

Zhu²,

Zhou³

2013

TCRM

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BackgroundA retrospective utilization study was performed to evaluate utilization patterns for enteral nutrition in a university teaching hospital.MethodsEnteral nutrition was divided into three types according to the nitrogen source, ie, total protein type [Nutrison Fibre®, Fresubin Energy Fibre®, Fresubin®, Supportan® (a special immunonutrition for cancer patients or patients with increased demands for omega-3 fatty acids), Fresubin Diabetes® (a diabetes-specific formula), Ensure®]; short peptide type (Peptison®); and amino acid type (Vivonex®). A pharmacoeconomic analysis was done based on defined daily dose methodology.ResultsAmong hospitalized patients taking enteral nutrition, 34.8% received enteral nutrition alone, 30% concomitantly received parenteral nutrition, and 35.2% received enteral nutrition after parenteral nutrition. Combined use of the different formulas was observed in almost all hospitalized patients receiving enteral nutrition. In total, 61.5% of patients received triple therapy with Nutrison Fibre, Fresubin Diabetes, and Supportan. Number of defined daily doses (total dose consumed/defined daily dose, also called DDDs) of formulas in descending order were as follows: Nutrison Fibre, Fresubin Energy Fibre, Fresubin Diabetes > Supportan > Peptison, Ensure > Vivonex, Fresubin. The ratio of the cumulative DDDs for the three types of enteral nutrition was 35:2.8:1 (total protein type to short peptide type to amino acid type). Off-label use of Fresubin Diabetes was also observed, with most of this formula being prescribed for patients with stress hyperglycemia. Only 2.1% of cancer patients received Supportan. There were 35 cases of near misses in dispensing look-alike or sound-alike enteral nutrition formulas, and one adverse drug reaction in an elderly malnourished patient who did not receive vitamin K1-enriched enteral nutrition during treatment with cefoperazone. After 4 months of the trial intervention, off-label use of Fresubin Diabetes was no longer endorsed by the Drug and Therapeutics Committee for nondiabetic patients, and the proportion of this formula prescribed for patients with stress hyperglycemia decreased by 20%, with a 10-fold increase in the amount of Supportan prescribed for cancer patients. Near misses in dispensing look-alike or sound-alike enteral nutrition were successfully abolished, and no severe coagulation disorders occurred after prophylactic administration of vitamin K1-enriched enteral nutrition in elderly malnourished patients receiving cefoperazone.ConclusionThis utilization study indicates that continuous quality improvement is necessary and that a Drug and Therapeutics Committee can play an important role in promoting rational and safe use of enteral nutrition. Appropriateness of this therapy still needs to be improved, especially in addressing the issues of non-evidence-based combined use of multiple enteral nutrition formulas, the relatively high rate of concomitant use of enteral and parenteral nutrition, off-label use of diabetes-specific Fresubin Diabetes, in...

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“…The ENT, either intragastric or trans-pyloric, should be the option of choice for these patients. Given the well documented benefits of ENT over PNT on the burned patients 31,32 , the latter shall be indicated only in reserved cases, where the digestive tract is not able to receive ENT 28 . We emphasize that, regardless of the route of administration, the importance of early nutrition therapy in these cases should be borne in mind.…”

Section: Immunonutrition In Traumamentioning

confidence: 99%

Terapia nutricional precoce no trauma: após o A, B, C, D, E, a importância do F (FEED)

Bicudo-Salomão

Moura

Aguilar-Nascimento

2013

Rev. Col. Bras. Cir.

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Um número significativo de mortes no trauma ocorre dias a semanas após a injúria inicial, sendo causado por infecções e insuficiência orgânica, relacionadas a hipercatabolismo e consequente desnutrição proteica aguda. A terapia nutricional deve ser planejada e incluída com as demais condutas de reanimação para pacientes politraumatizados e grandes queimados. A rápida aquisição de uma via para suporte nutricional é importante para inicio da terapia nutricional precoce em até 48 horas do atendimento. A via enteral é a opção preferencial no pós-operatório de pacientes traumatizado mas a via parenteral deve ser prescrita quando a enteral está contraindicada ou insuficiente. Após as medidas iniciais ditadas pelo ATLS, sintetizadas em A (air), B (breath), C (circulation), D (disability) e E (exposure), nós incluímos a letra F (feed) para enfatizar a importância do atendimento nutricional precoce no trauma.

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Early enteral feeding for burned patients—An effective method which should be encouraged in developing countries

Cited by 57 publications

References 8 publications

Outcomes of nasal bridling to secure enteral tubes in burn patients

Outcomes of nasal bridling to secure enteral tubes in burn patients

Prescribing practice and evaluation of appropriateness of enteral nutrition in a university teaching hospital

Terapia nutricional precoce no trauma: após o A, B, C, D, E, a importância do F (FEED)

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