Effectiveness of Early Enteral Feeding in Major Burn Patient

Sohn, Beong Hoon; Yang, Hyeong Tae; Lim, Hae Jun; Kim, Dohern; Hur, Jun; Chun, Wook; Kim, Jong Hyun; Lee, Samuel; Yoon, Hyeon; Cho, Yong Suk

Abstract

PURPOSE
Early enteral feeding is recommended in cases of critical illness. However, it is unclear whether this recommendation is of most benefit to extremely ill patients. From our experiences, our authors believed that early enteral nutrition can lead to better prognosis of ICU patients. We aim to clarify the efficacy of early enteral feeding.
METHODS
Eighty six critically ill patients were enrolled and grouped as "Early enteral feeding (EF)" and "Delayed enteral feeding (DF)" for this cross-sectional, prospective randomized observational study. To reduce the selection bias, we compare our groups to 20~39% (group A) TBSA (total body surface area, and 40~59% (group B) TBSA burned. BMI (body mass index), length of ICU stay, length of hospital stay, hospital mortality, serum prealbumin, serum transfferin and lymphocyte count data were collected over 28 days.
RESULTS
There were no statistical differences in measured outcomes between early and late feeding groups. In serologic test; prealbumin, transferrin and lymphocyte, there is also no statistical difference except 2nd, 4th week of lymphocyte. EF group has higher lymphocyte than DF group. In the group A, however, prealbumin and transferrin was high in EF group during the whole 4 weeks of study. Comparing the ICU stay and hospital mortality, there was also no statistical significance.
CONCLUSION
In this study, there is no significant association between hospital outcomes and timing of enteral feeding initiation. More active trials and many-sided studies will be needed to maximize the effect of early enteral nutritional support as a method to improve treatment for major burned patients.