Research:Protection from Catabolism in Major Burns: A New Formula for the Immediate Enteral Feeding of Burn Patients

The hypermetabolic state of patients with a major burn indicates an immediate need for calories and protein. These patients are at high risk for sepsis with intravenous hyperalimentation (IVH), and enteral feedings are not attempted during the resuscitation period, usually lasting 7 to 10 days. Twelve patients with major burns (40% to 70%) were fed nasoduodenally in the early postburn period with a new solution (3.5% Aminosyn, 25% Polycose, with appropriate addition of electrolytes and vitamins based on IVH solutions). All patients reached positive nitrogen balance in 9.8 ± 2.3 days and tolerated the enteral feeding extremely well, with no complaints of bloating or diarrhea. Metabolic assessment showed remarkable stability in these patients; the characteristic signs of hypermetabolism such as hyperglycemia and hypo-or hyperinsulinemia were absent. Furthermore, there was no persistent neutrophilia or leukocytosis, and a significant (P 0.001) increase in absolute lymphocytes between Day 0 and Day 14 of feeding. These data indicate that early enteral feeding of Polycose: Aminosyn is safe and well tolerated and that the small intestine will absorb nutrients readily in the early postburn period, leading to positive nitrogen balance, preventing loss of serum protein levels, assisting in the maintenance of normal carbohydrate metabolism, and restoring granulocytes and lymphocytes to normal ratios.