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Early Enteral Nutrition Does Not Decrease Hypermetabolism Associated with Burn Injury

Peck, Michael D. MD, ScD; Kessler, Mary RN, MSN; Cairns, Bruce A. MD; Chang, Yih-Harn PhD, RD, CNSD; Ivanova, Anastasia PhD; Schooler, Wesley MD

The Journal of Trauma: Injury, Infection, and Critical Care: December 2004 - Volume 57 - Issue 6 - p 1143-1149
doi: 10.1097/01.TA.0000145826.84657.38
Original Articles

Background: A prospective, randomized study was performed to compare the effects of early versus late enteral feeding on postburn metabolism.

Methods: Burn patients were randomized to receive enteral feedings either within 24 hours (early) or 7 days (late) of injury. Basal energy expenditure (BEE) was calculated from Harris-Benedict equations and resting energy expenditure (REE) was obtained from indirect calorimetry. The average daily energy expenditure (DEE) was expressed as REE/BEE.

Results: Average age, burn size, infections, and length of stay were similar between groups. Mortality between groups was similar (early, 28%; late, 38%) and not significantly influenced by inhalation injury. When controlled for percentage of total body surface area burn, inhalation injury, and age, the early group had an increased rather than decreased DEE, with a mean DEE calorie 0.17 more than the late group (p = 0.07).

Conclusion: Early enteral feeding does not decrease the average energy expenditure associated with burn injury.

From the Department of Surgery (M.D.P., B.A.C., W.S.), University of North Carolina Healthcare (M.K., Y.C.), School of Public Health, (A.I.), University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Submitted for publication September 23, 2003.

Accepted for publication August 6, 2004.

Sponsored by the North Carolina Jaycee Burn Center and, in part, by grant RR00046 from the General Clinical Research Center Program of the Division of Research Resources, National Institutes of Health.

Presented at the 63rd Annual Meeting of the American Association for the Surgery of Trauma, September 11–13, 2003, Minneapolis, Minnesota.

Address for reprints: Michael D. Peck, MD, ScD, North Carolina Jaycee Burn Center, University of North Carolina Hospitals, 101 Manning Drive, Chapel Hill, NC 27514; email:

© 2004 Lippincott Williams & Wilkins, Inc.