Nutritional Risk, Nutritional Status and Some Biochemical Parameters In Adult Burn Patients in Burn Intensive Care Unit: A Prospective Study

Yıl 2024, Cilt: 7 Sayı: 6, 253 - 261, 15.11.2024

Çiler Özenir , Gül Kızıltan

https://doi.org/10.19127/bshealthscience.1560769

Öz

Nutritional therapy is very important in burn patients and plays a role in the prevention and treatment of malnutrition. Therefore, it is necessary to assess nutritional status, prevent or minimize nutritional problems, and monitor nutritional therapy. This study was conducted to determine the nutritional risk, nutritional status and biochemical parameters of adult burn patients in the burn intensive care unit. The 59 patients (women: 16, men: 43) between the ages of 19-64 were included in the study. Parameters such as NRS-2002 (admission and discharge), dietary intake, nutritional support status, serum albumin, and total protein (admission and discharge) were evaluated to determine the nutritional risk and nutritional status of the patients. In addition, body weight, mid-upper arm circumference, and triceps skinfold thickness were measured and body mass index was calculated (admission and discharge). The duration of hospitalization and burn percentage of men patients were higher than women (P<0.05). A significant decreases were determined in the mean body weight, body mass index, and triceps skinfold thickness of men patients at discharge compared to admission (P<0.05). In men patients, a statistically significant difference was found in serum albumin, hemoglobin, and hematocrit values between admission and discharge (P<0.05). A statistically significant difference was found in NRS-2002 scores at admission and discharge in both genders, and the scores increased (P<0.05). While a significant relationship was found between immunonutrition support and gender (P<0.05), no relationship was found between genders in terms of the diet given and the consumption status of the diet intake (P>0.05). No statistically significant difference was found between genders in terms of feeding duration with nutritional support products, energy intake with nutritional support products and diet, macronutrients, and total energy expenditure values (P>0.05). Since burn injuries can cause serious metabolic disorders, impaired nutritional status was encountered during hospitalization. While the treatment process was positively affected by the increase in the NRS-2002 score during hospitalization, a decrease in parameters such as albumin, total protein, and anthropometric measurement values brought about by the catabolic process was encountered. Therefore, to prevent or treat malnutrition, the nutritional status of patients should be evaluated at the time of hospitalization and they should be able to receive the necessary nutritional support.

Anahtar Kelimeler

Burn, Nutritional risk, NRS-2002, Nutritional status, Albumin, Total protein

Etik Beyan

Ethics committee approval was received from Başkent University Non-Interventional Clinical Trials Ethics Committee by the Declaration of Helsinki (Project number: KA12/234, Decision number: 13/45). A signed written consent form was obtained from each participant by face-to-face interview.

Destekleyen Kurum

There is no support institution.

Proje Numarası

This study is not within the scope of the project.

Teşekkür

This article is extracted from Çiler Özenir's Master's thesis entitled “The determination of nutritional status and biochemical findings of burn patients undergoing inpatient treatment”, supervised by Prof. Dr. Gül Kızıltan (Master’s Thesis, Başkent University, Ankara, Türkiye, 2013). We would like to thank burn intensive care unit chief Prof. Dr. Ahmet Çınar YASTI, from whom we had the opportunity to benefit from their experiences, and moral support throughout the study.

Kaynakça

• Albayrak Y, Temiz A, Albayrak A, Peksöz R, Albayrak F, Tanrıkulu Y. 2018. A retrospective analysis of 2713 hospitalized burn patients in a burns center in Turkey. Turkish J Trauma Emerg Surg, 24(1): 25-30.
• Bolayır B. 2014. A validity and reliability study of nutritional assessment method NRS-2002 (Nutritional Screening Test-2002) in hospitalized patients. Internal Medicine Speciality Thesis, Hacettepe University, Institute of Health Sciences, Ankara, Türkiye, pp: 61.
• Chan LC, Lee MS, Ou YN, Cheng HL, Wang CH. 2018. Energy requirements for ICU burn patients in whom the total body surface area affected exceeds 50 percent: a practical equation. Asia Pac J Clin Nutr, 27(6): 1182-1189.
• Czapran A, Headdon W, Deane AM, Lange K, Chapman MJ, Heyland DK. 2015. International observational study of nutritional support in mechanically ventilated patients following burn injury. Burns, 41(3): 510-518.
• Douglas CC, Lawrence JC, Bush NC, Oster RA, Gower BA, Darnell BE. 2007. Ability of the Harris Benedict formula to predict energy requirements differs with weight history and ethnicity. Nutr Res, 27(4): 194-199.
• Durmuş M, Muhsiroğlu Ö, Yapici AK, Bayram Y, Eski M. 2016. Yanıkta tıbbi beslenme tedavisi. Turk J Plast Surg, 24(4): 166-172.
• Gürbüz K, Demir M. 2022. Epidemiological and clinical characteristics and outcomes of inpatient burn injuries in older adults. Turkish J Trauma Emerg Surg, 28(2): 162-169.
• Hejazi N, Mazloom Z, Zand F, Rezaianzadeh A, Amini A. 2016. Nutritional assessment in critically ill patients. Iran J Med Sci, 41(3): 171-179.
• Herndon DN, Hart DW, Wolf SE, Chinkes DL, Wolfe RR. 2001. Reversal of catabolism by beta-blockade after severe burns. N Engl J Med, 345: 1223-1229.
• Karahan S, Sezer Ceren RE, Ünsaldı M. 2021. Yanık hastasının beslenme gereksinimi: güncel öneriler. CUSBED, 6(3): 249-258.
• Kondrup J, Rasmussen HH, Hamberg O, Stanga Z, An ad hoc ESPEN Working Group. 2003. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 22(3): 321-336.
• Kreymann KG, Berger MM, Deutz NEP, Hiesmayr M, Jolliet P, Kazandjiev G, Nitenberg G, van den Berghe G, Wernerman J, DGEM, Ebner C, Hartl W, Heymann C, Spies C, ESPEN. 2006. ESPEN guidelines on enteral nutrition: intensive care. Clin Nutr, 25(2): 210-223.
• Lochs H, Allison SP, Meier R, Pirlich M, Kondrup J, Schneider St, van den Berghe G, Pichard C. 2006. Introductory to the ESPEN guidelines on enteral nutrition: terminology, definitions and general topics. Clin Nutr, 25(2): 180-186.
• Machado MN, Gragnani A, Ferreira ML. 2011. Burns, metabolism and nutritional requirements. Nutr Hosp, 26(4): 692-700.
• Maday KR. 2017. The importance of nutrition in critically ill patients. JAAPA. 30(1): 32-37.
• McDowell MA, Fryar CD, Ogden CL, Flegal KM. 2008. Anthropometric reference data for children and adults: United States, 2003–2006. Natl Health Stat Rep, 22(10): 1-48.
• Nişancı Kılınç F, Özenir Ç, Eşer Durmaz S, Bayındır Gümüş A, Çakır B. 2023. Determination of malnutrition and quality of life at the time of hospitalization of patients. BSJ Health Sci, 6(4): 640-649.
• Önder H. 2018. Nonparametric statistical methods used in biological experiments. BSJ Eng Sci, 1(1): 1-6.
• Ostadrahimi A, Nagili B, Asghari-Jafarabadi M, Beigzali S, Zalouli H, Lak S. 2016. A proper enteral nutrition support improves sequential organ failure score and decreases length of stay in hospital in burned patients. Iran Red Crescent Med J, 18(2): e21775.
• Özkan Kuşcu Ö, Aktay M, Destegül D, Kuşcu F, Özcengiz D. 2021. Yoğun bakım hastalarında inflamasyon belirteçlerinin mortalite tahmininde kullanımı. Kırıkkale Üniv Tıp Fak Derg, 23(1): 75-82.
• Poulia KA, Klek S, Doundoulakis I, Bouras E, Karayiannis D, Baschali A, Passakiotou M, Chourdakis M. 2017. The two most popular malnutrition screening tools in the light of the new ESPEN consensus definition of the diagnostic criteria for malnutrition. Clin Nutr, 36(4): 1130-1135.
• Ren Y, Wang L, Zhan J, Liao W, Hu R, Luo J, Cheng X. 2023. An overview of current research on nutritional support for burn patients: A bibliometric analysis from 1983 to 2022. Nutrition, 111: 112027.
• Rodriguez L. 2004. Nutritional status: assessing and understanding its value in the critical care setting. Crit Care Nurs Clin North Am, 16(4): 509-514.
• Rousseau AF, Losser MR, Ichai C, Berger MM. 2013. ESPEN endorsed recommendations: nutritional therapy in major burns. Clin Nutr, 32: 497-502.
• Saffle JR. 2007. Nutritional support of the burned patient. In Herndon DN, editor. Total burn care. Elsevier Health Sciences, Amsterdam, the Netherland, pp: 398-419.
• Shields BA, Doty KA, Chung KK, Wade CE, Aden JK, Wolf SE. 2013. Determination of resting energy expenditure after severe burn. J Burn Care Res, 34(1): e22-8.
• Sözen İ, Guldogan CE, Kismet K, Sabuncuoğlu MZ, Yasti AÇ. 2015. Outpatient burn management and unnecessary referrals. Turkish J Trauma Emerg Surg, 21(1): 27-33.
• Sungurtekin H, Sungurtekin U, Oner O, Okke D. 2008. Nutrition assessment in critically ill patients. Nutr Clin Pract, 23(6): 635-641.
• Suri MP, Singh Dhingra VJ, Raibagkar SC, Mehta DR. 2006. Nutrition in burns: need for an aggressive dynamic approach. Burns, 32(7): 880-884.
• WHO. 2010. World Health Organization: A healthy lifestyle - WHO recommendations. URL= https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations (accessed date: August 1, 2024).
• Windle EM. 2004. Audit of successful weight maintenance in adult and paediatric survivors of thermal injury at a UK regional burn centre. J Hum Nutr Dietet, 17: 435-441.