P065 - CHALLANGES AND STRATEGIES OF NUTRITIONAL THERAPY IN PATIENTS WITH BURNS AND INHALATION INJURIES: A CASE SERIES

P065

CHALLANGES AND STRATEGIES OF NUTRITIONAL THERAPY IN PATIENTS WITH BURNS AND INHALATION INJURIES: A CASE SERIES

N. Petkovic^1,*, D. Maksimovic¹, M. Bezmarevic²

¹Military Medical Academy, Belgrade, Serbia, ²Unit for Perioperative Nutrition, Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia

Rationale: Nutritional therapy represent a vital part of the treatment in patients with burns. Patients with burns frequently experience inadequate nutrition due to hypermetabolism and its  complications, and increased risk for malnutrition.

Methods: This case series describes the nutritional intervention for three young burn patients (18 year old female; 17 and 24 year old males) with severe inhalation injuries sustained in a fire. Enteral feeding started 36 h after injury via  nasogastric tube. Nutritional requirements were calculated using the Harris-Benedict, Toronto equations and also with indirect calorimetry. Energy requirements vary over time, with the largest increases being observed during the second week after injury. In the course of further nutritional treatment, significant challenges included not only the management of fluid resuscitation, but also the development of pneumonia secondary to inhalation injury and the onset of acute respiratory distress syndrome in two patients. The targeted nutritional demands were difficult to meet due to renal dysfunction and hemodynamic instability. With daily monitoring and individualized therapy, the challenges were gradually overcome. Preference was given to enteral nutrition rich in omega 3 fatty acids and micronutrients. Parenteral nutrition was added in one patient with inadequate nutrient intake.

Results: This case series emphasizes the importance of creating a good nutritional plan that will meet all the challenges of burn therapy.

Conclusion: The primary goal of nutritional support in burn patients is to fulfill the increased caloric requirements caused by the hypermetabolic state while avoiding overfeeding.

Disclosure of Interest: None declared