Torres AA

Language: Spanish
References: 0
Page: 255-69
PDF size: 465.46 Kb.

ABSTRACT

Rationale: Nutritional support (NS) should become a comprehensive part of health care provided to burn children and adolescents in order to contribute to post-injury survival and the effectiveness of medical surgical actions. There is little information on the state of NS in hospital units caring for the burn child adolescent. Objective: To present the state of NS as provided to burn children adolescents at the Burn Service, “Juan Manuel Márquez” Pediatric Teaching Hospital (Havana city, Cuba). Study design: Retrospective, analytical. Material and method: Clinical and demographical data belonging to 265 children and adolescents (Males: 65.3%; Average age: 5.9 ± 4.4 years; Ages < 1 year: 6.1%) cared for between 2000 – 2015 (BSA > 10%: 66.7%; Length of stay > 15 days: 66.0%; Escharectomy + Skin grafts: 65.7%; Deceased: 4.9%) were recovered from the historical records of the hospital Burn Service, along with procedural features of administered NA schemes. Results: Food and nutritional care provided to patients cared for at Service were distributed as follows: Diet prescription: 94.7%; Vitamin-mineral supplementation: 96.6%; Oral enteral supplementation (also known as volitional enteral nutrition): 14.7%; Tube-assisted feeding: 0.8%; Non-volitional enteral nutrition: 3.8%; and Parenteral nutrition: 62.6%; respectively. Breastfeeding was preserved in two children of the study serie. Average energy provisions behaved as follows: Diet prescription: 52.5 ± 35.2 Kcal.Kg bodyweight-1.24 hours-1; Oral enteral supplementation: 494.6 ± 417.4 Kcal.24 hours-1.patient-1; Non-volitional enteral nutrition: 97.3 ± 50.3 Kcal.Kg bodyweight-1.24 hours-1; and Parenteral nutrition: 10.9 ± 8.7 Kcal.Kg bodyweight-1.24 hours-1. Complications rate was 78.6%. Sepsis (local + general), anemia, disorders of peripheral utilization of glucose (resulting in hypoglicemia as well as hyperglicemia) and diarrheas were the most frequent complications. Conclusions: Oral route was preserved for supporting nutritional status by means of food intake as primary nutritional intervention. Hospital diet prescription was accompanied by the other forms of NS in order to provide supramaximal quantities of nonprotein- energy. There are still patients in whom coherent NS schemes could not be articulated due to the impact of burns and ensuing aggression.