Nutritional Therapy for the burn patient.

If a large NG tube is inserted, what should be checked to r/o delayed gastric emptying?

Gastric residuals should be checked to r/o delayed gastric emptying.

Hyper-metabolic state.

Hyper-metabolic state proportional to the size of the wound occurs after a major burn injury.

How should you begin the feedings for the burn patient?

In general, begin the feedings slowly at a rate of 20 to 40 mL/hr and increase to the goal rate within 24 to 48 hours.

How does early enteral feeding benefit the burn patient?

Early enteral feeding, usually with smaller-bore tubes, preserves GI function, increases intestinal blood flow, and promotes optimal conditions for wound healing.

How often should you assess bowel sounds in the burn patient?

Assess bowel sounds every 8 hours.

What is often given to meet the caloric needs of a burn patient?

Calorie-containing nutritional supplements and milkshakes are often given to meet the caloric needs. ----- Protein powder can also be added to food and liquids.

What is elevated in the burn patient?

Core temperature is elevated.

Enteral feedings (gastric or intestinal) for the burn patient have almost entirely replaced what?

Enteral feedings (gastric or intestinal) have almost entirely replaced parenteral feeding.

Massive catabolism in a burn patient can occur and is characterized by what?

Massive catabolism can occur and is characterized by protein breakdown and increased gluconeogenesis. Failure to supply adequate calories and protein leads to malnutrition and delayed healing.

Nutritional needs for the burn patient.

Once fluid replacement needs have been addressed, nutrition takes priority in the initial emergent phase.

Resting metabolic expenditure may be increased by how much?

Resting metabolic expenditure may be increased by 50% to 100% above normal in patients with major burns.

When are supplemental vitamins started for the injured burn patient?

Supplemental vitamins may be started in the emergent phase, with iron supplements often given in the acute phase.

Intubated patients and those with larger burns require what?

These patients require additional support.

Non-intubated patients with a burn of less than 20% TBSA can do what?

These patients will generally be able to eat enough to meet their nutritional needs.

Catecholamines.

These stimulate catabolism and heat production, and are increased with a burn injury.

Early and aggressive nutritional support within several hours of the burn injury can decrease what?

This can decrease mortality risks and complications, optimize healing of the burn wound, and minimize the negative effects of hyper-metabolism and catabolism.