Expert consensus on enteral nutrition care for adult patients with severe burns (2024 edition)

doi:10.3760/cma.j.cn501225-20240229-00078

Volume 40 Issue 9

Sep. 2024

Turn off MathJax

Article Contents

Abstract

References

Supplements

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2024 > 40(9): 801-811

Chinese Burn Association,Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare.Expert consensus on enteral nutrition care for adult patients with severe burns (2024 edition)[J].Chin J Burns Wounds,2024,40(9):801-811.DOI: 10.3760/cma.j.cn501225-20240229-00078.

Citation:

PDF( 920 KB)

Expert consensus on enteral nutrition care for adult patients with severe burns (2024 edition)

doi: 10.3760/cma.j.cn501225-20240229-00078

Funds:

National Key Research and Development Program of China 2021YFA1101100

Received Date: 2024-02-29

Abstract

Abstract

Enteral nutrition is one of the main nutritional treatments for patients with severe burns. In order to promote standardized, safe, and effective implementation of enteral nutrition care by clinical nurses, the consensus writing group conducted literature retrieval, quality evaluation, evidence synthesis, and expert consultation based on evidence of evidence-based medicine and guided by Delphi method on 11 topics including indications and initiation timing of enteral nutrition, hospital infection control, nutritional risk screening, swallowing function assessment, gastrointestinal function assessment, energy assessment, feeding route, infusion management, blood glucose management, nutritional status monitoring, and nutritional transition in adult patients with severe burns, and developed Expert consensus on enteral nutrition care for adult patients with severe burns (2024 edition) to provide a reference for nurses' clinical practice.
- Burns,
- Enteral nutrition,
- Nursing care,
- Expert consensus

Li Ning, Institute of Burn Research, State Key Laboratory of Trauma and Chemical Poisoning, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China, Email: 276806@tmmu.edu.cnZhang Yin, Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China, Email: inazhang2001@163.com

FullText(HTML)

References(69)

References

[1]	韩春茂,张莉萍,吴攀.从理论到实践浅论严重烧伤患者的精准营养支持[J].中华烧伤与创面修复杂志,2022,38(8):701-706.DOI: 10.3760/cma.j.cn501225-20220517-00189.
[2]	彭曦.重症烧伤患者的代谢分期及营养治疗策略[J].中华烧伤杂志,2021,37(9):805-810.DOI: 10.3760/cma.j.cn501120-20210802-00264.
[3]	RousseauAF,PantetO,HeylandDK.Nutrition after severe burn injury[J].Curr Opin Clin Nutr Metab Care,2023,26(2):99-104.DOI: 10.1097/MCO.0000000000000904.
[4]	彭曦.烧伤临床营养新视角[J].中华烧伤杂志,2019,35(5):321-325.DOI: 10.3760/cma.j.issn.1009-2587.2019.05.001.
[5]	GuoF,ZhouH,WuJ,et al.A prospective observation on nutrition support in adult patients with severe burns[J].Br J Nutr,2019,121(9):974-981.DOI: 10.1017/S0007114519000217.
[6]	KurmisR,NichollsC,SingerY,et al.An investigation of early enteral nutrition provision in major burn patients in Australia and New Zealand[J].Nutr Diet,2022,79(5):582-589.DOI: 10.1111/1747-0080.12746.
[7]	李茂君,陈华玲,鞠阳阳,等.烧伤重症监护病房护士实施肠内营养的知信行现状横断面调查及影响因素分析[J].中华烧伤与创面修复杂志,2023,39(9):874-881.DOI: 10.3760/cma.j.cn501225-20220522-00198.
[8]	RousseauAF,LosserMR,IchaiC,et al.ESPEN endorsed recommendations: nutritional therapy in major burns[J].Clin Nutr,2013,32(4):497-502.DOI: 10.1016/j.clnu.2013.02.012.
[9]	TaylorBE,McClaveSA,MartindaleRG,et al.Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)[J].Crit Care Med,2016,44(2):390-438.DOI: 10.1097/CCM.0000000000001525.
[10]	ISBI Practice Guidelines Committee,SubcommitteeSteering,SubcommitteeAdvisory.ISBI practice guidelines for burn care[J].Burns,2016,42(5):953-1021.DOI: 10.1016/j.burns.2016.05.013.
[11]	JormAF.Using the Delphi expert consensus method in mental health research[J].Aust N Z J Psychiatry,2015,49(10):887-897.DOI: 10.1177/0004867415600891.
[12]	王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.
[13]	BischoffSC,SingerP,KollerM,et al.Standard operating procedures for ESPEN guidelines and consensus papers[J].Clin Nutr,2015,34(6):1043-1051.DOI: 10.1016/j.clnu.2015.07.008.
[14]	杨楠,赵巍,潘旸,等.针对临床实践指南科学性、透明性和适用性的评级工具研发[J].中华医学杂志,2022,102(30):2329-2337.DOI: 10.3760/cma.j.cn112137-20220219-00340.
[15]	医学名词审定委员会肠外肠内营养学名词审定分委员会.肠外肠内营养学名词[M].北京:科学出版社,2019.
[16]	DeitchEA.Nutritional support of the burn patient[J].Crit Care Clin,1995,11(3):735-750.
[17]	JeschkeMG,MlcakRP,FinnertyCC,et al.Burn size determines the inflammatory and hypermetabolic response[J].Crit Care,2007,11(4):R90.DOI: 10.1186/cc6102.
[18]	MlcakRPInhalation injury from heat, smoke, or chemical irritantsUpToDate2023-10-062024-02-29https://www.uptodate.cn/contents/zh-Hans/inhalation-injury-from-heat-smoke-or-chemical-irritants MlcakRP.Inhalation injury from heat, smoke, or chemical irritants[EB/OL].UpToDate,(2023-10-06)[2024-02-29].https://www.uptodate.cn/contents/zh-Hans/inhalation-injury-from-heat-smoke-or-chemical-irritants.
[19]	RomanowskiKSOverview of nutrition support in burn patientsUpToDate2023-08-292024-02-29https://www.uptodate.cn/contents/zh-Hans/overview-of-nutrition-support-in-burn-patients RomanowskiKS.Overview of nutrition support in burn patients[EB/OL].UpToDate,(2023-08-29)[2024-02-29].https://www.uptodate.cn/contents/zh-Hans/overview-of-nutrition-support-in-burn-patients.
[20]	PuH,DoigGS,HeighesPT,et al.Early enteral nutrition reduces mortality and improves other key outcomes in patients with major burn injury: a meta-analysis of randomized controlled trials[J].Crit Care Med,2018,46(12):2036-2042.DOI: 10.1097/CCM.0000000000003445.
[21]	HeW,WangY,WangP,et al.Intestinal barrier dysfunction in severe burn injury[J/OL].Burns Trauma,2019,7:24[2024-02-29].https://pubmed.ncbi.nlm.nih.gov/31372365/.DOI: 10.1186/s41038-019-0162-3.
[22]	王德运,褚志刚,栾夏刚.重症烧伤的早期救治[J/CD].中华损伤与修复杂志(电子版),2021,16(5):383-388.DOI: 10.3877/cma.j.issn.1673-9450.2021.05.003.
[23]	米元元,黄海燕,尚游,等.中国危重症患者肠内营养治疗常见并发症预防管理专家共识(2021版)[J].中华危重病急救医学,2021,33(8):903-918.DOI: 10.3760/cma.j.cn121430-20210310-00357.
[24]	BoullataJI,CarreraAL,HarveyL,et al.ASPEN safe practices for enteral nutrition therapy [formula: see text][J]. JPEN J Parenter Enteral Nutr,2017,41(1):15-103.DOI: 10.1177/0148607116673053.
[25]	许静涌,杨剑,康维明,等.营养风险及营养风险筛查工具营养风险筛查2002临床应用专家共识(2018版)[J].中华临床营养杂志,2018,26(3):131-135.DOI: 10.3760/cma.j.issn.1674-635X.2018.03.001.
[26]	KondrupJ,JohansenN,PlumLM,et al.Incidence of nutritional risk and causes of inadequate nutritional care in hospitals[J].Clin Nutr,2002,21(6):461-468.DOI: 10.1054/clnu.2002.0585.
[27]	靳云云运用改良的营养风险筛查工具指导烧伤患者营养治疗的回顾性调查杭州浙江大学2015 靳云云.运用改良的营养风险筛查工具指导烧伤患者营养治疗的回顾性调查[D].杭州:浙江大学,2015.
[28]	HeylandDK,DhaliwalR,JiangX,et al.Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool[J].Crit Care,2011,15(6):R268.DOI: 10.1186/cc10546.
[29]	Alfonso OrtizL,JiangX,TurgeonAF,et al.Validation of the modified NUTrition Risk Score (mNUTRIC) in mechanically ventilated, severe burn patients: a prospective multinational cohort study[J].Burns,2021,47(8):1739-1747.DOI: 10.1016/j.burns.2021.05.010.
[30]	MaZ,ZhangY,ZhangQ,et al.Modified Nutrition Risk in Critically ill is an effective nutrition risk screening tool in severely burned patients, compared with Nutrition Risk Screening 2002[J].Front Nutr,2022,9:1007885.DOI: 10.3389/fnut.2022.1007885.
[31]	EdelmanDA,Sheehy-DeardorffDA,WhiteMT.Bedside assessment of swallowing is predictive of an abnormal barium swallow examination[J].J Burn Care Res,2008,29(1):89-96.DOI: 10.1097/BCR.0b013e31815f5a4c.
[32]	中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍评估与治疗专家共识(2017年版)第一部分评估篇[J]. 中华物理医学与康复杂志,2017,39(12):881-892. DOI: 10.3760/cma.j.issn.0254-1424.2017.12.001.
[33]	DePippoKL,HolasMA,RedingMJ.Validation of the 3-oz water swallow test for aspiration following stroke[J].Arch Neurol,1992,49(12):1259-1261.DOI: 10.1001/archneur.1992.00530360057018.
[34]	YangS,ParkJW,MinK,et al.Clinical practice guidelines for oropharyngeal dysphagia[J].Ann Rehabil Med,2023,47(Suppl 1):S1-S26.DOI: 10.5535/arm.23069.
[35]	ClaytonNA,WardEC,RumbachAF,et al.Influence of inhalation injury on incidence, clinical profile and recovery pattern of dysphagia following burn injury[J].Dysphagia,2020,35(6):968-977.DOI: 10.1007/s00455-020-10098-y.
[36]	SierpEL,KurmisR,LangeK,et al.Nutrition and gastrointestinal dysmotility in critically ill burn patients: a retrospective observational study[J].JPEN J Parenter Enteral Nutr,2021,45(5):1052-1060.DOI: 10.1002/jpen.1979.
[37]	Reintam BlaserA,MalbrainML,StarkopfJ,et al.Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems[J].Intensive Care Med,2012,38(3):384-394.DOI: 10.1007/s00134-011-2459-y.
[38]	中华医学会肠外肠内营养学分会.中国成人患者肠外肠内营养临床应用指南(2023版)[J].中华医学杂志,2023,103(13):946-974.DOI: 10.3760/cma.j.cn112137-20221116-02407.
[39]	亚洲急危重症协会中国腹腔重症协作组.重症病人胃肠功能障碍肠内营养专家共识(2021版)[J].中华消化外科杂志,2021,20(11):1123-1136.DOI: 10.3760/cma.j.cn115610-20211012-00497.
[40]	罗月,黎宁.严重烧伤患者早期肠内营养治疗的研究进展[J].中华烧伤杂志,2021,37(9):880-884.DOI: 10.3760/cma.j.cn501120-20210621-00223.
[41]	DelsoglioM,AchamrahN,BergerMM,et al.Indirect calorimetry in clinical practice[J].J Clin Med,2019,8(9):1387.DOI: 10.3390/jcm8091387.
[42]	彭曦.重症烧伤患者能量消耗与需求平衡:值得深入研究的问题[J].中华烧伤杂志,2013,29(4):331-334.DOI: 10.3760/cma.j.issn.1009-2587.2013.04.001.
[43]	解伟光,黎鳌,汪仕良.三医大烧伤营养公式临床疗效的观察[J].第三军医大学学报,1992,14(2):121-123.
[44]	KurmisR,HeathK,OoiS,et al.A prospective multi-center audit of nutrition support parameters following burn injury[J].J Burn Care Res,2015,36(4):471-477.DOI: 10.1097/BCR.0000000000000125.
[45]	SingerP,BlaserAR,BergerMM,et al.ESPEN guideline on clinical nutrition in the intensive care unit[J].Clin Nutr,2019,38(1):48-79.DOI: 10.1016/j.clnu.2018.08.037.
[46]	CederholmT,BarazzoniR,AustinP,et al.ESPEN guidelines on definitions and terminology of clinical nutrition[J].Clin Nutr,2017,36(1):49-64.DOI: 10.1016/j.clnu.2016.09.004.
[47]	DeaneAM,AdamMD,DhaliwalR,et al.Comparisons between intragastric and small intestinal delivery of enteral nutrition in the critically ill: a systematic review and meta-analysis[J].Crit Care,2013,17(3):R125.DOI: 10.1186/cc12800.
[48]	National Institute for Health and Care Excellence (NICE)Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition20062017-08-042024-02-29https://www.nice.org.uk/guidance/cg32 National Institute for Health and Care Excellence (NICE). Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition[EB/OL].2006(2017-08-04)[2024-02-29]. https://www.nice.org.uk/guidance/cg32.
[49]	石海燕,刘爱华,马骁,等.《成人鼻肠管的留置与维护》团体标准解读[J].中华急危重症护理杂志,2023,4(11):1011-1015.DOI: 10.3761/j.issn.2096-7446.2023.11.009.
[50]	中国急诊危重症患者肠内营养治疗专家共识组.中国急诊危重症患者肠内营养治疗专家共识[J].中华急诊医学杂志,2022,31(3):281-290.DOI: 10.3760/cma.j.issn.1671-0282.2022.03.004.
[51]	LiY,YeY,MeiY,et al.Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults[J].Biomed Eng Online,2018,17(1):21.DOI: 10.1186/s12938-018-0452-1.
[52]	WindleEM,BeddowD,HallE,et al.Implementation of an electromagnetic imaging system to facilitate nasogastric and post-pyloric feeding tube placement in patients with and without critical illness[J].J Hum Nutr Diet,2010,23(1):61-68.DOI: 10.1111/j.1365-277X.2009.01010.x.
[53]	Hemington-GorseSJ,SheppardNN,MartinR,et al.The use of the Cortrak Enteral Access System™ for post-pyloric (PP) feeding tube placement in a Burns Intensive Care Unit[J].Burns,2011,37(2):277-280.DOI: 10.1016/j.burns.2010.07.011.
[54]	ClarkA,ImranJ,MadniT,et al.Nutrition and metabolism in burn patients[J/OL].Burns Trauma,2017,5:11[2024-02-29].https://pubmed.ncbi.nlm.nih.gov/28428966/.DOI: 10.1186/s41038-017-0076-x.
[55]	中华护理学会T/CNAS 19─2020 成人肠内营养支持的护理2021 中华护理学会.T/CNAS 19─2020 成人肠内营养支持的护理[S].2021.
[56]	HiebertJM,BrownA,AndersonRG,et al.Comparison of continuous vs intermittent tube feedings in adult burn patients[J].JPEN J Parenter Enteral Nutr,1981,5(1):73-75.DOI: 10.1177/014860718100500173.
[57]	PantetO,StoecklinP,VernayA,et al.Impact of decreasing energy intakes in major burn patients: a 15-year retrospective cohort study[J].Clin Nutr,2017,36(3):818-824.DOI: 10.1016/j.clnu.2016.05.007.
[58]	LinJ,LiuY,KeL,et al.Feeding intolerance score in critically ill patients with enteral nutrition: a post hoc analysis of a prospective study[J].Nutr Clin Pract,2022,37(4):869-877.DOI: 10.1002/ncp.10788.
[59]	喻海涛,蔡丽,陈璐,等.基于容量的肠内营养输注方案对ICU患者营养摄入影响的Meta分析[J].中华急危重症护理杂志,2023,4(2):106-111.DOI: 10.3761/j.issn.2096-7446.2023.02.002.
[60]	WangL,WangY,LiHX,et al.Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review[J].Crit Care,2023,27(1):173.DOI: 10.1186/s13054-023-04439-0.
[61]	中国老年医学学会烧创伤分会,中华医学会烧伤外科学分会重症学组.成人烧伤俯卧位治疗全国专家共识(2022版)[J].中华烧伤与创面修复杂志,2022,38(7):601-609.DOI: 10.3760/cma.j.cn501120-20211208-00407.
[62]	臧芝栋,严正,惠皎洁,等.平均血糖波动幅度对严重烧伤患者预后的意义[J].中华烧伤杂志,2016,32(1):35-39.DOI: 10.3760/cma.j.issn.1009-2587.2016.01.010.
[63]	StoecklinP,DelodderF,PantetO,et al.Moderate glycemic control safe in critically ill adult burn patients: a 15 year cohort study[J].Burns,2016,42(1):63-70.DOI: 10.1016/j.burns.2015.10.025.
[64]	BarguesL,Cottez-GaciaS,JaultP,et al.Clinical and biological monitoring of nutritional status in severe burns[J].Pathol Biol (Paris),2009,57(7/8):524-529.DOI: 10.1016/j.patbio.2008.02.014.
[65]	韩春茂.烧伤患者(成人)的营养支持指南[J/CD].中华普通外科学文献(电子版),2008,2(1):6-7.DOI: 10.3969/j.issn.1674-0793.2008.01.003.
[66]	MastersB,WoodF.Nutrition support in burns--is there consistency in practice?[J].J Burn Care Res,2008,29(4):561-571.DOI: 10.1097/BCR.0b013e31817db85f.
[67]	MunnZNdegwaMDBurns nutrition: evaluation20212021-09-122024-02-29http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI8915 MunnZ, NdegwaMD. Burns nutrition: evaluation[EB/OL].2021(2021-09-12)[2024-02-29].http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI8915.
[68]	中国抗癌协会肿瘤营养专业委员会,国家市场监管重点实验室(肿瘤特医食品),中国营养保健食品协会特殊医学用途配方食品应用委员会.规范化外科营养诊疗示范病房标准[J/CD].肿瘤代谢与营养电子杂志,2022,9(2):175-184.
[69]	中华护理学会重症护理专业委员会,北京医学会肠外肠内营养学分会护理学组.神经重症患者肠内喂养护理专家共识[J].中华护理杂志,2022,57(3):261-264.DOI: 10.3761/j.issn.0254-1769.2022.03.001.

Relative Articles

[1]	Expert consensus on the treatment of second-degree burn wounds (2024 edition)Ⅰ: pre-hospital first aid and non-surgical treatment[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(1): 1-18. doi: 10.3760/cmaj.cn501225-20231019-00120
[2]	National expert consensus on clinical diagnosis and treatment of hot crush injury wound (2023 version)[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(3): 201-208. doi: 10.3760/cma.j.cn501225-20220608-00227
[3]	Expert consensus on the clinical treatment of burn patients complicated with Coronavirus infection (2023 version)[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(8): 701-712. doi: 10.3760/cma.j.cn501225-20230519-00176
[4]	Li Maojun, Chen Hualing, Ju Yangyang, Zeng Lijin, Li Ning. A cross-sectional survey and influencing factors analysis of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(9): 874-881. doi: 10.3760/cma.j.cn501225-20220522-00198
[5]	The Burn and Trauma Branch of Chinese Geriatrics Society, Critical Care Group of Chinese Burn Association. National expert consensus on prone position therapy in adult burn patients (2022 version)[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(7): 601-609. doi: 10.3760/cma.j.cn501120-20211208-00407
[6]	Liu Yan. National expert consensus on the aeromedical trans- portation of burn patients (2022 version)[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(2): 101-108. doi: 10.3760/cma.j.cn501120-20211025-00366
[7]	Wu Dan, Su Sen, Wei Yan, Peng Xi. Research progress of intestinal mucus barrier and the repair of intestinal damage after burn injury[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(8): 788-793. doi: 10.3760/cma.j.cn501225-20220701-00280
[8]	Luo Yue, Li Ning. Research advances on early enteral nutritional therapy in severe burn patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(9): 880-884. doi: 10.3760/cma.j.cn501120-20210621-00223
[9]	Jiang Bin, Shen Mingyan, Shen Tao. Nursing of one patient with extremely severe burn-blast combined injury complicated with acute kidney injury caused by dust explosion[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(7): 603-605. doi: 10.3760/cma.j.cn501120-20190415-00188
[10]	Liang Jingbing, Wang Pei, Feng Yanhai, Huang Yalan, Wang Fengjun, Ren Hui. Effects of sodium butyrate on intestinal barrier of severe scald mice and the related mechanism[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(1): 48-53. doi: 10.3760/cma.j.issn.1009-2587.2020.01.009
[11]	Wu Yuwen, Liu Jun, Jin Jun, Liu Lijun, Wu Yunfu. Effects of early enteral nutrition in the treatment of patients with severe burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(1): 40-46. doi: 10.3760/cma.j.issn.1009-2587.2018.01.008
[12]	The Burn and Trauma Branch of Chinese Geriatrics Society, Zhang Jiaping, Wang Weiyi. National experts consensus on application of pulse contour cardiac output monitoring technique in severe burn treatment (2018 version)[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(11): 776-781. doi: 10.3760/cma.j.issn.1009-2587.2018.11.011
[13]	The Burn and Trauma Branch of Chinese Geriatrics Society, Ming Zhiguo, Lei Jin, Duan Peng, Tan Jianglin, Lou Jihe, Di Haiping, Wang Deyun. National experts consensus on tracheotomy and intubation for burn patients (2018 version)[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(11): 782-785. doi: 10.3760/cma.j.issn.1009-2587.2018.11.012
[16]	FAN Jun, MENG Qing-yan, GUO Guang-hua, XIE Yong, LI Yue, HU Fu-sun, XIU Yi-ping, LI Tai-ran, MA Liang. Effect of early enteral immune nutrition on immune function of intestine in mice with severe burn[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2009, 25(2): 140-143. doi: 10．3760／cma．j．issn．1009-2587．2009．02．021
[17]	an Hong, Peng Xi, Wang Pei, Huang Yue-Sheng, Wang Shi-Liang. Influence of the enteral feeding of levorotatory arginine on severely burned patients during shock stage[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2005, 21(4): 251-254.
[18]	Chen Bin, Fu Jin-feng, Yuan Wei-gong, Xu Yan, Luo Zhi-hang, Wang Hong, Chen Zong-hua, Li Cui-ping. Study on the mechanism of protective effect of oral L-arginine on intestine after scald injury in rats[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2005, 21(4): 259-261.
[19]	CHEN Zhong-yong, GU Cai-zhi, WANG Shao-long, YU Bin, WANG Shi-Bang. Comparative study on the enteral and parenteral nutrition during early postburn stage in burn patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2004, 20(4): 217-219.
[20]	Explore enteral nutrition and repair injured intestine[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2004, 20(4): 196-197.