Dr Guy Stanley¹

¹University of Western Australia, Crawley, Australia

Abstract:

INTRODUCTION: Major burns cause a hypermetabolic state requiring increased calorie and protein intake. Parenteral nutrition (PN) can be used, but there are ongoing questions about its safety. Guidelines invariably recommend the early establishment of enteral nutrition (EN); however, this is not always possible, for instance, during severe illness. It is appropriate to update on treatment options, so this study reviews the recent literature on the safety and efficacy of parenteral nutrition in major, acute, paediatric burns.

METHODS: A literature search was conducted in April 2022 on the OVID database, covering EMBASE & CINAHL, including the search terms “paediatric”, “parenteral nutrition”, “PN”, and “burns”. Inclusion criteria were clinical, burn, in English and peer-reviewed studies from 2012 onwards, with full-texts.

RESULTS: Three studies were identified. Dylewski (2013) found that a low-calorie, high-nitrogen PN formula could safely replace or supplement EN. Tramonti (2018) implemented a nutrition protocol, including PN, with 12 patients using PN without complications. Seubmora (2022) found that PN within seven days of the burn was not associated with length of stay or 30-day mortality. No study evaluated peripheral parenteral nutrition.

CONCLUSION: Enteral nutrition remains the route of choice for feeding. PN may be safe in major, acute paediatric burns when total EN alone cannot meet requirements. There is level II-III evidence that PN may be safe in the first seven days after burns. Future studies might look at peripheral parenteral nutrition (PPN) and the proportion of PN supplementation given alongside EN to reduce the complications associated with TPN and EN.

Biography:

Surgical service registrar