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Safety and Tolerance of Intraoperative Enteral Nutrition Support in Pediatric Burn Patients
Background Multiple surgical procedures required by patients with extensive thermal injuries impedes delivery of adequate nutrition support, leading to caloric deficits, weight loss, delayed wound healing, and increased length of stay. The standard practice at our institution for >20 years has be...
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| Published in: | Nutrition in clinical practice 2019-10, Vol.34 (5), p.728-734 |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c3259-7e5dcfd62b68a2d1dc1518358f2d63fb0d436f324d3d0401a7210c7aa0e480ff3 |
| container_end_page | 734 |
| container_issue | 5 |
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| container_title | Nutrition in clinical practice |
| container_volume | 34 |
| creator | Sunderman, Christina A. Gottschlich, Michele M. Allgeier, Chris Warden, Glenn |
| description | Background
Multiple surgical procedures required by patients with extensive thermal injuries impedes delivery of adequate nutrition support, leading to caloric deficits, weight loss, delayed wound healing, and increased length of stay. The standard practice at our institution for >20 years has been to continuously infuse postpyloric enteral nutrition (EN) during surgery. The purpose of this review was to examine the safety and efficacy of intraoperative EN support.
Methods
A retrospective chart review of pediatric patients with burn injuries >30% total body surface area provided a 20‐year (1995–2014) safety assessment associated with intraoperative feeding along with an evaluation of gastrointestinal tolerance and efficacy. Continuous variables were summarized by mean and SD, whereas categorical variables were summarized by counts and percentages.
Results
The 20‐year review confirmed the safety of intraoperative feeding, as the assessment of 434 patients revealed no incidence of aspiration. Patients were successfully fed during an average of 8.4 ± 6.5 surgical procedures and received EN support for a mean of 49.9 ± 31.7 days. Uninterrupted nutrition delivery was well tolerated with minimal gastrointestinal intolerance. Patients achieved an average nitrogen balance of 3.1 ± 2.8 and 70% maintained ±10% of their body weight at time of discharge.
Conclusion
EN has been safely provided with marginal intolerance during surgical procedures over the past 20 years. Continuous nutrition support with negligible interruption is integral to meet nutrient needs for wound healing, preservation of weight and nutrition parameters, and optimize length of stay in pediatric patients with extensive thermal injuries. |
| doi_str_mv | 10.1002/ncp.10399 |
| format | article |
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Multiple surgical procedures required by patients with extensive thermal injuries impedes delivery of adequate nutrition support, leading to caloric deficits, weight loss, delayed wound healing, and increased length of stay. The standard practice at our institution for >20 years has been to continuously infuse postpyloric enteral nutrition (EN) during surgery. The purpose of this review was to examine the safety and efficacy of intraoperative EN support.
Methods
A retrospective chart review of pediatric patients with burn injuries >30% total body surface area provided a 20‐year (1995–2014) safety assessment associated with intraoperative feeding along with an evaluation of gastrointestinal tolerance and efficacy. Continuous variables were summarized by mean and SD, whereas categorical variables were summarized by counts and percentages.
Results
The 20‐year review confirmed the safety of intraoperative feeding, as the assessment of 434 patients revealed no incidence of aspiration. Patients were successfully fed during an average of 8.4 ± 6.5 surgical procedures and received EN support for a mean of 49.9 ± 31.7 days. Uninterrupted nutrition delivery was well tolerated with minimal gastrointestinal intolerance. Patients achieved an average nitrogen balance of 3.1 ± 2.8 and 70% maintained ±10% of their body weight at time of discharge.
Conclusion
EN has been safely provided with marginal intolerance during surgical procedures over the past 20 years. Continuous nutrition support with negligible interruption is integral to meet nutrient needs for wound healing, preservation of weight and nutrition parameters, and optimize length of stay in pediatric patients with extensive thermal injuries.</description><identifier>ISSN: 0884-5336</identifier><identifier>EISSN: 1941-2452</identifier><identifier>DOI: 10.1002/ncp.10399</identifier><identifier>PMID: 31448446</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; burns ; Burns - therapy ; Child ; enteral nutrition ; Enteral Nutrition - methods ; Female ; Humans ; Intraoperative Period ; Male ; Nursing ; nutrition support ; pediatrics ; Retrospective Studies ; safety ; Treatment Outcome</subject><ispartof>Nutrition in clinical practice, 2019-10, Vol.34 (5), p.728-734</ispartof><rights>2019 American Society for Parenteral and Enteral Nutrition</rights><rights>2019 American Society for Parenteral and Enteral Nutrition.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3259-7e5dcfd62b68a2d1dc1518358f2d63fb0d436f324d3d0401a7210c7aa0e480ff3</citedby><cites>FETCH-LOGICAL-c3259-7e5dcfd62b68a2d1dc1518358f2d63fb0d436f324d3d0401a7210c7aa0e480ff3</cites><orcidid>0000-0002-3484-4768</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31448446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sunderman, Christina A.</creatorcontrib><creatorcontrib>Gottschlich, Michele M.</creatorcontrib><creatorcontrib>Allgeier, Chris</creatorcontrib><creatorcontrib>Warden, Glenn</creatorcontrib><title>Safety and Tolerance of Intraoperative Enteral Nutrition Support in Pediatric Burn Patients</title><title>Nutrition in clinical practice</title><addtitle>Nutr Clin Pract</addtitle><description>Background
Multiple surgical procedures required by patients with extensive thermal injuries impedes delivery of adequate nutrition support, leading to caloric deficits, weight loss, delayed wound healing, and increased length of stay. The standard practice at our institution for >20 years has been to continuously infuse postpyloric enteral nutrition (EN) during surgery. The purpose of this review was to examine the safety and efficacy of intraoperative EN support.
Methods
A retrospective chart review of pediatric patients with burn injuries >30% total body surface area provided a 20‐year (1995–2014) safety assessment associated with intraoperative feeding along with an evaluation of gastrointestinal tolerance and efficacy. Continuous variables were summarized by mean and SD, whereas categorical variables were summarized by counts and percentages.
Results
The 20‐year review confirmed the safety of intraoperative feeding, as the assessment of 434 patients revealed no incidence of aspiration. Patients were successfully fed during an average of 8.4 ± 6.5 surgical procedures and received EN support for a mean of 49.9 ± 31.7 days. Uninterrupted nutrition delivery was well tolerated with minimal gastrointestinal intolerance. Patients achieved an average nitrogen balance of 3.1 ± 2.8 and 70% maintained ±10% of their body weight at time of discharge.
Conclusion
EN has been safely provided with marginal intolerance during surgical procedures over the past 20 years. Continuous nutrition support with negligible interruption is integral to meet nutrient needs for wound healing, preservation of weight and nutrition parameters, and optimize length of stay in pediatric patients with extensive thermal injuries.</description><subject>Adolescent</subject><subject>burns</subject><subject>Burns - therapy</subject><subject>Child</subject><subject>enteral nutrition</subject><subject>Enteral Nutrition - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Period</subject><subject>Male</subject><subject>Nursing</subject><subject>nutrition support</subject><subject>pediatrics</subject><subject>Retrospective Studies</subject><subject>safety</subject><subject>Treatment Outcome</subject><issn>0884-5336</issn><issn>1941-2452</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kEtPwzAQhC0EoqVw4A8gH-EQ6lcS5whVgUpVqdRy4hC5fkhGqRNsB9R_j6GFG6edHX07Wg0AlxjdYoTI2MkuCVpVR2CIK4YzwnJyDIaIc5bllBYDcBbCG0KY05KfggHFjHHGiiF4XQmj4w4Kp-C6bbQXTmrYGjhz0Yu2S0a0HxpOXUyygYs-ehtt6-Cq77rWR2gdXGplRfIlvO99WtOJdjGcgxMjmqAvDnMEXh6m68lTNn9-nE3u5pmkJK-yUudKGlWQTcEFUVhJnKdHc26IKqjZIMVoYShhiirEEBYlwUiWQiDNODKGjsD1Prfz7XuvQ6y3NkjdNMLptg81IRzlhFZlntCbPSp9G4LXpu683Qq_qzGqv7usU5f1T5eJvTrE9putVn_kb3kJGO-BT9vo3f9J9WKy3Ed-AfPjfj8</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Sunderman, Christina A.</creator><creator>Gottschlich, Michele M.</creator><creator>Allgeier, Chris</creator><creator>Warden, Glenn</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3484-4768</orcidid></search><sort><creationdate>201910</creationdate><title>Safety and Tolerance of Intraoperative Enteral Nutrition Support in Pediatric Burn Patients</title><author>Sunderman, Christina A. ; Gottschlich, Michele M. ; Allgeier, Chris ; Warden, Glenn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3259-7e5dcfd62b68a2d1dc1518358f2d63fb0d436f324d3d0401a7210c7aa0e480ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>burns</topic><topic>Burns - therapy</topic><topic>Child</topic><topic>enteral nutrition</topic><topic>Enteral Nutrition - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Period</topic><topic>Male</topic><topic>Nursing</topic><topic>nutrition support</topic><topic>pediatrics</topic><topic>Retrospective Studies</topic><topic>safety</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sunderman, Christina A.</creatorcontrib><creatorcontrib>Gottschlich, Michele M.</creatorcontrib><creatorcontrib>Allgeier, Chris</creatorcontrib><creatorcontrib>Warden, Glenn</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition in clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sunderman, Christina A.</au><au>Gottschlich, Michele M.</au><au>Allgeier, Chris</au><au>Warden, Glenn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and Tolerance of Intraoperative Enteral Nutrition Support in Pediatric Burn Patients</atitle><jtitle>Nutrition in clinical practice</jtitle><addtitle>Nutr Clin Pract</addtitle><date>2019-10</date><risdate>2019</risdate><volume>34</volume><issue>5</issue><spage>728</spage><epage>734</epage><pages>728-734</pages><issn>0884-5336</issn><eissn>1941-2452</eissn><abstract>Background
Multiple surgical procedures required by patients with extensive thermal injuries impedes delivery of adequate nutrition support, leading to caloric deficits, weight loss, delayed wound healing, and increased length of stay. The standard practice at our institution for >20 years has been to continuously infuse postpyloric enteral nutrition (EN) during surgery. The purpose of this review was to examine the safety and efficacy of intraoperative EN support.
Methods
A retrospective chart review of pediatric patients with burn injuries >30% total body surface area provided a 20‐year (1995–2014) safety assessment associated with intraoperative feeding along with an evaluation of gastrointestinal tolerance and efficacy. Continuous variables were summarized by mean and SD, whereas categorical variables were summarized by counts and percentages.
Results
The 20‐year review confirmed the safety of intraoperative feeding, as the assessment of 434 patients revealed no incidence of aspiration. Patients were successfully fed during an average of 8.4 ± 6.5 surgical procedures and received EN support for a mean of 49.9 ± 31.7 days. Uninterrupted nutrition delivery was well tolerated with minimal gastrointestinal intolerance. Patients achieved an average nitrogen balance of 3.1 ± 2.8 and 70% maintained ±10% of their body weight at time of discharge.
Conclusion
EN has been safely provided with marginal intolerance during surgical procedures over the past 20 years. Continuous nutrition support with negligible interruption is integral to meet nutrient needs for wound healing, preservation of weight and nutrition parameters, and optimize length of stay in pediatric patients with extensive thermal injuries.</abstract><cop>United States</cop><pmid>31448446</pmid><doi>10.1002/ncp.10399</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3484-4768</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0884-5336 |
| ispartof | Nutrition in clinical practice, 2019-10, Vol.34 (5), p.728-734 |
| issn | 0884-5336 1941-2452 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2280523975 |
| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Adolescent burns Burns - therapy Child enteral nutrition Enteral Nutrition - methods Female Humans Intraoperative Period Male Nursing nutrition support pediatrics Retrospective Studies safety Treatment Outcome |
| title | Safety and Tolerance of Intraoperative Enteral Nutrition Support in Pediatric Burn Patients |
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