oa Wits Journal of Clinical Medicine - Enteral nutrition in the unstable burns patients - research article

Volume 2 Number 2
  • ISSN : 2618-0189
  • E-ISSN: 2618-0197



Background: Enteral feeding is a widely accepted method to maintain nutrition in severely burnt patients who cannot eat. However, controversy exists over the safety of enteral feeding in an intensive care unit (ICU) setting where burns patients are haemodynamically unstable and on high-dose vasopressor support. Enteral feeding increases the oxygen requirements of the gastrointestinal mucosa. If vasopressor agents decrease the splanchnic blood flow, there is a risk of mucosal necrosis.

Objective: The aim of this study was to determine the safety and efficiency of early and ongoing enteral feeding in a cohort of severely burnt patients in an ICU.

Methods: This retrospective study was over a five-year period at the Chris Hani Baragwanath Academic Hospital (CHBAH), involving adult burns patients admitted to the ICU requiring vasopressor support and enteral feeding. Of the 1109 adult burns patients admitted to the adult burns unit at CHBAH, 475 patients required intensive care. Of these, 44 patients with burns, >20% of the total burnt surface area, required both ventilation and intravenous vasopressor support and were entered into the study.

Results: Of the 44 patients, 11 (25%) experienced delayed gastric emptying with gastric aspirates >500 ml/6 h, 4 (9%) vomiting and 9 (20%) developed diarrhoea. However, 41 (93%) tolerated full enteral feeding after a temporary intolerance while receiving intravenous vasopressor support. In 3 (7%) patients, enteral feeding was discontinued due to persistent intolerance.

Conclusion: In this cohort of severely burnt patients requiring ventilation and intravenous vasopressor support, there were no serious complications associated with enteral feeding.

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