1Fiona Stanley Hospital State Adult Burns Unit
This systematic review aimed to synthesise all available research and provide evidenced-based recommendations regarding the effectiveness and safety of perioperative nutrition for patients with burn injuries. A quantitative review of effectiveness, following the JBI systematic review methodology was undertaken.
Patients requiring surgical management of an acute burn who received perioperative enteral feeding were compared to patients who experienced perioperative fasting. Outcome measures were mortality, wound infection, length of stay, pulmonary aspiration, pneumonia, calorie delivery, ventilator days, wellbeing and any other relevant outcomes.
Seven studies met the inclusion criteria. The results indicated intraoperative post pyloric feeding was safe, with nil aspiration events reported in any study. The effectiveness of perioperative nutrition was demonstrated by the consistent increased caloric provision in patients who received intraoperative post pyloric feeding. Other outcome measures relating to the effectiveness of perioperative nutrition showed varied results. Wellbeing was improved with shorter perioperative fasting in a case report. This is consistent with literature regarding other surgical patients however the certainty of the results was very low. The outcomes of mortality, wound infection, length of stay, and ventilator days were inconsistent, with some studies showing improvements with perioperative feeding and others indicating worsening of these measures. Small sample sizes, high heterogeneity and major confounding factors between control and intervention groups contributed to very low certainty of findings.
Further research on the topic is recommended.
Senior Dietitian at the State Adult Burns Unit of WA since 2015. Has been working as a Clinical Dietitian for over 25 years. Qualifications include a Bachelor of Science (Nutrition and Food Science), Graduate Diploma in Dietetics and a Masters of Clinical Science. Is an Accredited Practising Dietitian. The thesis for this systematic review formed the major component of the degree of Masters of Clinical Science via the University of Adelaide.