Mr Sandeep B¹, Professor Fiona Wood¹, Prof  Suzanne Rea¹, Dr Helen Douglas¹

¹Fiona Stanley Hospital, Willeton, Australia

Abstract:

Introduction

Acute burns nutrition is mainly managed in form of enteral nutrition. Total parenteral nutrition (TPN) is not frequently used in burns due to studies showing increased mortality.

Often in acute burns patients, especially large TBSA burns, patients with comorbidities, the gut motility, and absorption are compromised leading to subpar nutrition optimization. During such a phase to continue healing/recovery it is essential to continue some form of nutrition. We feel in such a subset of patients TPN has a major role to tide over nutritional crises promoting early recovery and preventing mortality.

Method:

Patient data from the adult state burns unit in Fiona Stanley Hospital, WA, which required ICU management during acute burns management were collected. This cohort was chosen since most of these patients had large surface area burns, Inhalational burns, or had comorbidities.

These patients were divided into TPN and Non-TPN groups. The outcome like Length of stay (LOS), Mortality, and Episodes of sepsis was compared between the two groups.

The groups were normalized for the variables and compared using statistical analysis.

Results:

There was no statistical difference in LOS, Episodes of sepsis, or Mortality among the two groups. In all the patients who received TPN, it was noted that TPN was used as a bridging therapy when Enteral nutrition was not effectively getting absorbed. Once the gut absorption returned to normal, TPN was seized and enteral nutrition was continued till acceptable oral intake was achieved.

Discussion: It has been noted in our study population that TPN did not negatively impact the outcomes and is safe. Hence TPN should be considered as a bridging method to optimize nutrition when Enteral nutrition is not effective.

Biography:

Qualified  general surgeon and dual-qualified plastic surgeon from India and Australia. Major interest in trauma and Burns reconstruction. Undergone 5 years fellowship training in the above  fileds.

Presently work as consultant burns surgeon in Fiona Stanley Hospital and consultant plastic surgeon in Royal Perth Hospital, WA.