University of Adelaide (Australia) researchers are working to solve one of the
biggest problems of caring for critically ill burns victims: how to
provide them with the nutrition they need to survive.
Getting the
right level and type of nutrition to burns victims is a key to their
recovery and survival. But these patients often face severe challenges.
"Major
burns result in almost a doubling of the body's metabolic rate, so the
body is using up energy much quicker than in a healthy person," says Professor Marianne Chapman, from the University's School of Medicine and the Intensive Care Unit at the Royal Adelaide Hospital (RAH).
"One
of the difficulties faced by healthcare professionals is how to provide
enough energy so that the patient does not experience what we call a
'metabolic debt', which may ultimately result in the person's death.
How that nutrition is delivered also poses problems, especially if the
patient requires mechanical breathing assistance in intensive care."
Professor
Chapman, Associate Professor Adam Deane and their team have a research
program studying gut function, nutrition delivery and how it affects
recovery in survival in all types of critically ill patients, in the
hopes of developing world's best practice in this area. They have a
number of international collaborations – the research into burns
nutrition has been conducted with colleagues from Canada.
In a
recent study of 90 patients, they found that burns victims often
suffered from substantial energy and protein deficits in the first few
days of their admission to hospital.
"There are multiple reasons
for this, including delays in the initiation of feeding, poor initial
tolerance of the feed – which is provided directly into the patients'
stomachs – and interruptions due to medical procedures, such as
emergency surgery," Professor Chapman says.
She says nutritional
guidelines have already been developed specifically for patients with
burns, but the current guidelines have been largely based on expert
opinion. "With our research, we're attempting to put some scientific
rigour behind the practice," she says.
"The results of our
studies so far show there is very clearly an association between
deficits in energy and protein and patient mortality. Women also are
more likely to die than men, which reflects the findings of
international studies and is something that needs to be looked into
further.
"At this stage we still don't know the optimum level of
calories and protein needed to increase a patient's chances of
survival. Further research is needed in this area," she says.
Professor Chapman and Associate Professor Deane are members of the Centre of Research Excellence in Translating Nutritional Science to Good Health
at the University of Adelaide and RAH, which is funded by the National
Health and Medical Research Council (NHMRC). They have recently been
awarded a $3.5 million grant from the NHMRC to continue their research
into nutrition delivery in patients in intensive care.