PP147
CAUSES OF ENTERAL NUTRITION INTERRUPTION AND THEIR TEMPORAL DISTRIBUTION IN CRITICALLY ILL BURN PATIENTS: AN OBSERVATIONAL STUDY FROM A SPECIALIZED BURN ICU IN LIMA, PERU
RATIONALE
M. L. Franco Kuroki1,*, M. A. Franco Kuroki1, A. J. Morales Alvarez1, A. K. D. R. Poma Pinillos1
1Lima, Hospital Nacional Azobispo Loayza, Lima, Peru
Rationale: In critically ill burn patients, enteral nutrition (EN) delivery is frequently interrupted by surgical and clinical factors, generating caloric deficits linked to increased mortality and infectious complications.
Methods: Retrospective study in the burn ICU of a national referral hospital in Lima, Peru. Adults (≥18 years) with TBSA burned ≥20% admitted June–December 2024 were included. Weekly caloric deficit and causes of EN interruption were recorded: surgical procedures, hemodynamic instability, gastrointestinal (GI) complications, and mechanical failures. A linear mixed-effects model with random intercept per patient assessed temporal evolution of caloric deficit.
Results: Forty-nine patients; mean age 30 years (95%CI: 27–33), 78% male, mean TBSA 45±12%. Surgical procedures were the leading cause of EN interruption in all weeks (week 1: 79.6%; week 2: 85.0%; week 3: 93.9%; week 4: 88.0%). Hemodynamic instability predominated in week 1 (20.4%), falling to 0% from week 3. GI complications rose from 0% to 10.2% by week 4. Mechanical failures were rare (<2%). Mean caloric deficit decreased from 128.6±215.9 kcal (week 1) to 90.1±154.2 kcal (week 4), representing 6.2–8.4% of estimated requirements. The mixed-effects model showed no significant between-week differences
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Conclusion: Surgical procedures are the dominant cause of EN interruption in critically ill burn patients, exceeding 80% across all weeks. Despite remaining below established risk thresholds, the sustained caloric deficit carries clinical relevance.
References: McClave SA, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient. JPEN. 2023;47(1):3–56.
Wischmeyer PE, et al. Nutrition therapy in the ICU: current evidence and future directions. Crit Care Med. 2024;52(1):45–58.
Disclosure of Interest: None declared