Intraoperative enteral nutrition in severe burn patients: Australia and New Zealand practice perspectives and review of current evidence
Collette Massy-Westropp1, 1The Royal Adelaide Hospital
Abstract
Background:
Major burns induce a hypermetabolic state and providing adequate nutrition is crucial for a patient’s recovery. The initiation of early enteral nutrition is an important standard practice in burns centres to improve outcomes. Fasting during the perioperative period can contribute to caloric intake deficits in burns patients, which can be addressed by administering intraoperative enteral nutrition. However, the feasibility and safety of intraoperative enteral nutrition in severe burn patients may vary depending on the specific circumstances and the patient’s condition.
Methods:
An online survey seeking quantitative and qualitative answers was sent to burns centre (ward) and intensive care unit (ICU) based dietitians regarding their use of intraoperative enteral nutrition. Additionally, a literature review of evidence pertaining to intraoperative enteral nutrition was conducted.
Results:
A representative from each of the burns centres in Australia and New Zealand participated in the study. Most respondents reported that intraoperative enteral feeding was uncommon practice at their institution. Current available evidence suggests that there is no statistically significant difference in mortality with the use of intraoperative enteral nutrition, but that there is a notable increase in nutritional delivery compared to patients fasted without intraoperative feeding.
Conclusions:
Intraoperative enteral nutrition can be utilised to maintain calorie delivery to burns patients required to fast for surgical procedures. Nevertheless, further evidence is required to substantiate its role within Australian practice.
Biography
Collette Massy-Westropp is an unaccredited registrar in plastic and reconstructive surgery at the Royal Adelaide Hospital.