Nutritional support practices and perspectives in adult patients with severe burns: A survey amongst dietitians in Australia and New Zealand Burns Centres

Collette Massy-Westropp¹, Michael Liss Sara Dowling Lee-Anne Chapple
¹The Royal Adelaide Hospital

Abstract

Background:

Nutrition is critical in managing major burns, where the stress response induces a hypermetabolic and catabolic state. Current endorsed Australian and New Zealand Burn Association (ANZBA) and European Society for Clinical Nutrition and Metabolism (ESPEN) recommendations promote initiation of early nutritional support to meet the increased demands. Data from the Burns Registry of Australia and New Zealand indicates variable practice in the delivery of enteral nutrition (EN). Understanding practices impacting nutrition delivery is significant as inadequate EN is linked with increased morbidity and mortality.

Aims:

1.To describe current nutrition support practices in burns centres across Australia and New Zealand.
2.To evaluate consistency and compliance against evidence-based practice guidelines
Methods:

An online survey seeking quantitative and qualitative answers was sent to burns centre (ward) and intensive care unit (ICU) based dietitians regarding current nutritional support practices for adult patients with severe burns.

Results:

17 dieticians representing most of the burn centres in Australia and New Zealand completed the survey. All dieticians reported involvement in the care of major burns patients within 48 hours of admission. The participants reported variable timeframes and methods for commencing EN burns as well as diverse approaches to monitoring the micronutrient status of this patient group.

Conclusions:

There is variation in EN initiation across burns centres despite the common goal to adhere to endorsed recommendations. This study highlights the need for further research into the barriers to best practice nutrition in major burns patients to ensure burns centres can implement consistent, evidence-based nutrition management.

Biography

Collette Massy-Westropp is an unaccredited registrar working on the Plastic and Reconstructive Surgery unit at the Royal Adelaide Hospital in South Australia.