Effects of Nutritional Supplementation on Prealbumin Concentrations inPediatric Burn Patients: A Randomized, Controlled Trial

Introduction: This prospective, randomized study was designed to measure the effect of nutritional supplemen- tation on serum prealbumin (transthyretin) in pediatric burn patients in seven burn centers in Russia. The primary measure was change in serum prealbumin from baseline to Day 7. Methods: Fifty-four children age 1-10 years with a TBSA burn of at least 15% were enrolled into this study. Patients had baseline serum prealbumin levels < 10 mg/dL and were capable of exclusive oral feeding within 72 hours of hospitaliza- tion. One-hundred-sixteen children were screened, with 54 meeting eligibility criteria, 28 subjects in the control group and 26 in the supplement group. Patients were randomized to receive the typical hospital diet for mild to moderate burn pa- tients or the same diet plus additional oral nutritional supplementation. The additional enteral supplementation was 299 kcal/day for most of the subjects. Results: Nutritional supplementation significantly increased serum prealbumin levels of the subjects from baseline to Day 7. At Day 7, children consuming the supplementation had a mean ± standard error change in prealbumin concentration of 8.44 ± 1.13 mg/dL and children on hospital diet only had a change of 5.47 ± 0.80 mg/dL, with a difference of 2.97 mg/dL (p=0.0265). There were no significant differences in baseline serum prealbumin concentration, nor were there differences for adverse events or safety concerns related to study product. Conclusions: The increase of prealbumin related to enteral supplementation may provide future guidance for nutritional management of pediatric burn patients or patients with increased energy and protein needs.