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Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 4-36

Recent Concepts in Nutritional Therapy in Critically Ill Burn Patients

Department of Hand Surgery, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India

Correspondence Address:
Mariappan Natarajan
Department of Hand Surgery, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai-600116
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijnpnd.ijnpnd_58_18

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In developing countries such as India, burn injury is still a major and frequent cause of mortality and morbidity. Nutrition therapy aims to provide adequate and early nutrition for patients suffering from burn injuries. Metabolic support during heightened inflammatory state is essential to make sure adequate treatment of burn patients. It is essential to reduce the force and effects of the hypermetabolic response, aim for healing of wounds, and help to reduce negative catabolism effects. At the same time, care of surgical and medical needs of the patient is crucial for good clinical outcomes. Nutritional sustain is an essential and integral component of burn care that requires an aggressive multifaceted approach. Impaired wound healing, dysfunction of multiple organs, increased chances of infection, and death are largely prevented by an adequate nutrition care along with proper wound management. Catecholamine and corticosteroids, inflammatory mediator levels, are increased, and this hypermetabolic response leads to catastrophic results in the postburn injury period. A shift from preventing malnutrition to disease modulation in nutrition support in critically ill patients is being aimed at present. Uncontrolled inflammation causes severe metabolic derangement in burn patients. Major challenges are assessment of nutritional status of the patient and estimation of nutrient requirements. Careful decision-making for safe use of enteral or parenteral nutrition and an aggressive nutrient delivery are required. The course of disease can be altered favorably to a great extent by supplementation of specific nutrients. Nutritional factors with positive effects on immunity and in cell regulation include glutamine, arginine, and essential fatty acids, known as immunonutrients. They reduce the severity of illness and improve response to treatment of patients. Nutrition support specialists are trying to improve the management protocols and technological advances such as nanotechnology and biomarkers will take the nutrition management to greater advances.

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