PD912 - IMMUNONUTRITION IN SEVERE PEDIATRIC BURNS: EFFECTS ON CLINICAL RECOVERY-A SYSTEMATIC REVIEW

PD912

IMMUNONUTRITION IN SEVERE PEDIATRIC BURNS: EFFECTS ON CLINICAL RECOVERY-A SYSTEMATIC REVIEW

D. Alvarez Salazar^1,*, L. A. Lopez-Romero¹

¹Santander, Universidad Industrial de Santander, Bucaramanga, Colombia

Rationale: Pediatric burns have a global incidence of 0.79–1% and remain a significant cause of childhood mortality^{(Lozano et al., 2024)}. These injuries trigger a systemic inflammatory response with metabolic, immunological, and endocrine alterations, increasing nutritional demands. Glutamine and arginine, recognized immunonutrients, have shown benefits in adults; however, their efficacy in pediatric populations remains uncertain^{(Wei et al., 2024)}. This systematic review evaluated their effects compared with standard nutrition in children with severe burns.

Methods: A comprehensive search was conducted in PubMed, Embase, BVS, Cochrane, Ovid, Elsevier, and Springer, complemented by grey literature. The review was registered in PROSPERO (CRD420251028040) and followed PRISMA and Cochrane guidelines. Studies in English, Spanish, and Portuguese were included without time restrictions, using MeSH, DeCS, and adapted free-text terms.

Results: A total of 4,059 records were identified; after duplicate removal, 3,332 were screened. 17 full-text articles were assessed, and 7 studies were included. Considerable heterogeneity was observed in study design, populations, dosing, and intervention duration. Glutamine (0.35–0.57 g/kg/day) and arginine (commercial formulas) were the most frequently evaluated^{(Tihista et al., 2020)}. Several studies lacked direct clinical outcomes, focusing instead on guidelines or immunological parameters^{(Mehta et al, 2017)}_. Overall, no consistent clinical benefits were demonstrated, and findings were inconclusive, potentially influenced by dosage and baseline nutritional status.

Conclusion: Available evidence is limited and of low methodological quality, with small sample sizes and risk of bias. No definitive conclusions can be drawn regarding the effectiveness and safety of glutamine and arginine in children with severe burns, highlighting the need for robust clinical trials in this population.

Disclosure of Interest: None declared