CH LIPIDS
CALORIES PROTEINS INMUNO
NUTRITION
ESPEN GUIDELINES: BURNS
Do not pass 60% for any
glycemic imbalance. Do
not pass 5 mg/kg/min. it
could go to 7 gr/kag/day
for both.
Check if there is any
propofol. If there is, we
substract the gr of fat it
has to not overfeed.
Consider TBSA +20% as
major burn and TBSA as
-20%
Depending of TBSA but it
goes around 1.5 to 2 gr/kf
in adults and 1.5-3 gr/kg in
kids Start within 12 hrs of injury and
always go for oral route
We need an adequate intake of macro and micro nutrients, metabolic modulation and glycemic control
for optimal outcomes after major burn injuries
Consider TBSA +20% as
major burn and TBSA as
-20% Keep -35% or go to 15-30
g/day in adults for non
nutritional lipids.
Glutamine is essential for
lymphocites and
enterocites production.
For critical patients we
should consider 0.3 g/kg/d
for 5 to 10 days in adults
and less than 3 days in
kids.
No evidence for arginine
supplementation
Use of intravenous
infusion of insulin
Evidence that vitamin C and E
helps with oxidative stress
reduction and improves
wound healing.
Vitamin C dose should be 0.5
to 1 gr/day in accute phase.
Check copper, selenium and
zinc. Check 7-8 days if 20-40%
TBSA, 2 weeks with 40-60%
and +30 days for +60% TBSA
15% reduces infectious
morbility, also use this %
is there is any respiratory
insuffiency, sepsis,
EXTRAS
Use cristaloides within 24 to 48 hrs to keep
normal pressure.
Massive liquids reanimations can cause edema
If there is oral intolerence or broncoaspiration
risk
EN preferablly, gastric route if not use
transpiloric route. Specially if there is
gastrointestinal intolerence or they can’t reach
kcal goals.
CHECK REFEEDDING
SYNDROME
