Protein Metabolism and Therapy in Burn Injury

Boucher, J. Le; Cynober, Luc

doi:10.1159/000177981

Cited by 16 publications

(4 citation statements)

References 45 publications

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“…19 In our study cohort, concentrations of BCAAs (valine, leucine, and isoleucine) were particularly elevated, and these amino acids are considered specific to proteolysis. 30–32 Over the first week following injury, a severely injured individual’s energy requirement is nearly double the baseline energy requirement in an uninjured individual. 16 Following injury, muscle catabolism yields BCAAs to serve as carbon chains for unmet energy needs; valine is converted to carbohydrates, leucine to fats, and isoleucine to fats and carbohydrates.…”

Section: Discussionmentioning

confidence: 99%

“…However, this is unlikely to be the primary driver because gut absorption of amino acids is tightly regulated; most enteral amino acids are metabolized via a first pass in the liver and are thereby prevented from entering systemic circulation. 38 Moreover, concentrations of BCAAs became elevated over time; BCAAs are relatively more specific to muscle catabolism 30–32 and are not supplemented in our enteral formulas.…”

Section: Discussionmentioning

confidence: 99%

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Use of Metabolomics to Trend Recovery and Therapy After Injury in Critically Ill Trauma Patients

et al. 2016

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Metabolomics can function as a serial, comprehensive, and potentially personalized tool to characterize metabolism after injury. A targeted metabolomics approach was associated with ongoing oxidative stress, impaired nucleotide synthesis, and initial suppression of protein metabolism followed by increased nitrogen turnover. This technique may provide new therapeutic and nutrition targets in critically injured patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of Metabolomics to Trend Recovery and Therapy After Injury in Critically Ill Trauma Patients

et al. 2016

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“…Burn is considered as one of the most hypermetabolic states, which might persists up to 2 years after occurrence ( 19 ). Nutritional therapy is a crucial part of burn care ( 3 , 9 , 12 , 20 ). Multiple studies have pointed out that malnourished patients undergo worse outcomes, including prolonged LOS in hospital, increased readmission and mortality, in comparison to well-nourished patients ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Burned patients have the highest metabolic rate among all critically ill patients ( 1 , 2 ). Increased energy expenditure can cause malnutrition, with sever body weight loss and, also, negative nitrogen balance ( 3 , 4 ). After burn injury, a broad systemic response starts immediately, which may adversely affect immune function ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

A Proper Enteral Nutrition Support Improves Sequential Organ Failure Score and Decreases Length of Stay in Hospital in Burned Patients

Ostadrahimi¹,

Nagili²,

Jafarabadi³

et al. 2016

Iran Red Crescent Med J

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Background:Severe burned patients developed metabolic imbalances and systemic inflammatory response syndrome (SIRS), which can lead to malnutrition, impaired immunologic response, multiple organ failure and death. Studies have shown that providing an early and adequate nutrition support can lower hypermetabolic response and improve the outcome. Unfortunately, little emphasis has been given to the role of nutritional support, especially for demonstrating the importance of a proper nutritional support in determining the outcome of critically burned patients.Objectives:This study was designed to determine the possible protective effect of early and adequate nutrition support on sequential organ failure assessment (SOFA) score and length of stay (LOS) in hospital, in thermal burn victims.Patients and Methods:Thirty patients with severe thermal burn (More than 20% of total body surface area [TBSA] burn), on the first day in the intensive care unit, joined this double-blinded randomized controlled clinical trial. Patients were randomly divided into two groups: control group (group C, 15 patients) received hospital routine diet (liquid and chow diet, ad libitum) while intervention group (group I, 15 patients) received commercially prepared solution, with oral or tube feeding. The caloric requirement for these patients was calculated, according to the Harris-Benedict formula. The SOFA score was also measured on admission (SOFA0), day 2 (SOFA1), day 5 (SOFA2) and day 9 (SOFA3), consequently. The difference between the last measurement (SOFA3) and day 2 (SOFA1) was calculated.Results:The results showed that there was a significant change between SOFA3 and SOFA1, {-1[(-1) – 0], P = 0.013 vs. -1 [(-2) - 0], P = 0.109}. Mean LOS in hospital, for patients consuming commercial standard food, also proved to be shorter than those consuming hospital routine foods (17.64 ± 8.2 vs. 23.07 ± 11.89).Conclusions:This study shows that an adequate nutritional support, in patients with severe burn injury, can improve SOFA score. It is also more cost-effective, resulting in a shorter LOS in hospital.

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