A Proper Enteral Nutrition Support Improves Sequential Organ Failure Score and Decreases Length of Stay in Hospital in Burned Patients

BACKGROUND: Severe burned patients developed metabolic imbalances and systemic inflammatory response syndrome (SIRS), which can lead to malnutrition, impaired immunologic response, multiple organ failure and death. Studies have shown that providing an early and adequate nutrition support can lower hypermetabolic response and improve the outcome. Unfortunately, little emphasis has been given to the role of nutritional support, especially for demonstrating the importance of a proper nutritional support in determining the outcome of critically burned patients. OBJECTIVES: This study was designed to determine the possible protective effect of early and adequate nutrition support on sequential organ failure assessment (SOFA) score and length of stay (LOS) in hospital, in thermal burn victims. PATIENTS AND METHODS: Thirty patients with severe thermal burn (More than 20% of total body surface area [TBSA] burn), on the first day in the intensive care unit, joined this double-blinded randomized controlled clinical trial. Patients were randomly divided into two groups: control group (group C, 15 patients) received hospital routine diet (liquid and chow diet, ad libitum) while intervention group (group I, 15 patients) received commercially prepared solution, with oral or tube feeding. The caloric requirement for these patients was calculated, according to the Harris-Benedict formula. The SOFA score was also measured on admission (SOFA0), day 2 (SOFA1), day 5 (SOFA2) and day 9 (SOFA3), consequently. The difference between the last measurement (SOFA3) and day 2 (SOFA1) was calculated. RESULTS: The results showed that there was a significant change between SOFA3 and SOFA1, {-1[(-1) – 0], P = 0.013 vs. -1 [(-2) - 0], P = 0.109}. Mean LOS in hospital, for patients consuming commercial standard food, also proved to be shorter than those consuming hospital routine foods (17.64 ± 8.2 vs. 23.07 ± 11.89). CONCLUSIONS: This study shows that an adequate nutritional support, in patients with severe burn injury, can improve SOFA score. It is also more cost-effective, resulting in a shorter LOS in hospital.