Nutritional Management in Severe Burn Patients: A Case Report.

Clinical nutrition research Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI:10.7762/cnr.2025.14.1.1
Seolbin Kim
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Abstract

Patients with severe burns frequently experience inadequate nutrition due to hypermetabolism and its associated complications, substantially increasing the risk of malnutrition. This case report describes the nutritional intervention for a 54-year-old male patient admitted with total body surface area burns of 42.4%, including 15% third-degree burns caused by flames. It highlights the importance of active nutritional support and continuous monitoring during the management of complex burn cases. Upon admission, the patient's nutritional intake was restricted due to fluid resuscitation, frequent surgeries requiring fasting, renal dysfunction, and gastrointestinal complications. Nutritional requirements were calculated using the Harris-Benedict and Toronto equations; however, it was difficult to meet the targeted nutritional demands during the initial Nutrition Support Team (NST) consultation due to renal dysfunction and hemodynamic instability. Subsequent efforts, including oral nutritional supplements and adjunctive parenteral nutrition, were implemented; however, multifactorial issues, such as systemic deterioration and complications, further exacerbated the patient's nutritional status. As a result, the patient experienced a 15% reduction in his usual body weight, decreasing from 100 kg to 85 kg. This case underscores the vital role of proactive NST involvement and ongoing nutritional intervention in the management of patients with severe burns and complex complications.

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严重烧伤患者经常会因代谢亢进及其相关并发症而导致营养不足,从而大大增加了营养不良的风险。本病例报告描述了一名 54 岁男性患者的营养干预情况,患者的总体表面积烧伤面积达 42.4%,其中 15%为火焰造成的三度烧伤。报告强调了在处理复杂烧伤病例时积极提供营养支持和持续监测的重要性。入院时,由于液体复苏、频繁的手术需要禁食、肾功能障碍和胃肠道并发症等原因,患者的营养摄入受到了限制。营养需求是通过哈里斯-本尼迪克特方程和多伦多方程计算得出的;然而,由于肾功能不全和血流动力学不稳定,在营养支持小组(NST)最初会诊期间很难满足目标营养需求。随后采取的措施包括口服营养补充剂和辅助性肠外营养;然而,全身状况恶化和并发症等多因素问题进一步加剧了患者的营养状况。结果,患者的正常体重下降了 15%,从 100 公斤降至 85 公斤。本病例强调了积极的 NST 参与和持续的营养干预在治疗严重烧伤和复杂并发症患者中的重要作用。
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