Metabolic staging and nutritional treatment strategies of severely burned patients

Peng Xi

doi:10.3760/cma.j.cn501120-20210802-00264

Volume 37 Issue 9

Sep. 2021

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2021 > 37(9): 805-810

Peng X.Metabolic staging and nutritional treatment strategies of severely burned patients[J].Chin J Burns,2021,37(9):805-810.DOI: 10.3760/cma.j.cn501120-20210802-00264.

Citation:

Peng X.Metabolic staging and nutritional treatment strategies of severely burned patients[J].Chin J Burns,2021,37(9):805-810.DOI: 10.3760/cma.j.cn501120-20210802-00264.

Citation:

Peng X.Metabolic staging and nutritional treatment strategies of severely burned patients[J].Chin J Burns,2021,37(9):805-810.DOI: 10.3760/cma.j.cn501120-20210802-00264.

PDF( 878 KB)

Metabolic staging and nutritional treatment strategies of severely burned patients

doi: 10.3760/cma.j.cn501120-20210802-00264

Peng Xi^,

Clinical Medical Research Center, Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injury, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China

Funds:

General Program of National Natural Science Foundation of China 81971838

Major Clinical Research Foundation of the Third Military Medical University 2018XLC2006

More Information

Corresponding author: Peng Xi, Email: pxlrmm@163.com
Received Date: 2021-08-02

Abstract

Abstract

The complexity of burn metabolism and limitations of its cognition are the core factors leading to dissatisfactory efficacy of nutritional therapy in severe burn patients. Precise understanding of burn metabolic rules is a prerequisite for improving the pertinence and effectiveness of nutritional therapy. The previous division of burn metabolic stages based on energy consumption did not pay enough attention to substance metabolism, so it is difficult to fully comprehend the overall change pattern and stage characteristics of burn metabolism. Through the effective integration of the metabonomics, physiomics, and clinical data, combining the pathophysiological characteristics of burns at different clinical phases, this paper suggested that the metabolism of severe burns should be divided into four stages and proposed the corresponding nutritional strategies and measures according to different metabolic characteristics, in order to provide a basis for further enhancing the nutritional efficacy in burn patients.
- Burns,
- Metabolism,
- Nutrition therapy,
- Parenteral nutrition,
- Enteral nutrition

FullText(HTML)

References(33)

References

[1]	SaffleJR, GravesC, CochranA. Nutritional support of the burned patient[M]//Herndon DN. Total burn care. Netherlands: Elsevier, 2012: 333-353.
[2]	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.
[3]	ClarkA,ImranJ,MadniT,et al.Nutrition and metabolism in burn patients[J/OL].Burns Trauma,2017,5:11[2021-08-02].https://pubmed.ncbi.nlm.nih.gov/28428966/. DOI: 10.1186/s41038-017-0076-x.
[4]	XuHZ,YuYM,MaH,et al.Glucose metabolism during the early “flow phase” after burn injury[J].J Surg Res,2013,179(1):e83-90.DOI: 10.1016/j.jss.2012.02.037.
[5]	MertS,BulutogluB,ChuC,et al.Multiorgan metabolomics and lipidomics provide new insights into fat infiltration in the liver, muscle wasting, and liver-muscle crosstalk following burn injury[J].J Burn Care Res,2021,42(2):269-287.DOI: 10.1093/jbcr/iraa145.
[6]	BadoiuSC,MiricescuD,Stanescu-SpinuII,et al.Glucose metabolism in burns-what happens?[J].Int J Mol Sci,2021,22(10):5159.DOI: 10.3390/ijms22105159.
[7]	彭曦.烧伤高代谢机制的再认识及调控策略[J].中华烧伤杂志,2013,29(2):139-143.DOI: 10.3760/cma.j.issn.1009-2587.2013.02.012.
[8]	KnuthCM,AugerC,JeschkeMG.Burn-induced hypermetabolism and skeletal muscle dysfunction[J].Am J Physiol Cell Physiol,2021,321(1):C58-C71.DOI: 10.1152/ajpcell.00106.2021.
[9]	GauglitzGG, FinnertyCC, HerndonDN, et al. Modulation of the hypermetabolic response after burn injury[M]//Herndon DN. Total burn care. Netherlands: Elsevier, 2012: 355-360.
[10]	JeschkeMG,ChinkesDL,FinnertyCC,et al.Pathophysiologic response to severe burn injury[J].Ann Surg,2008,248(3):387-401.DOI: 10.1097/SLA.0b013e3181856241.
[11]	彭曦.我国烧伤营养的发展历程与未来方向[J/CD].中华损伤与修复杂志:电子版,2020,15(5):331-336.DOI: 10.3877/cma.j.issn.1673-9450.2020.05.001.
[12]	PorterC,TompkinsRG,FinnertyCC,et al.The metabolic stress response to burn trauma: current understanding and therapies[J].Lancet,2016,388(10052):1417-1426.DOI: 10.1016/S0140-6736(16)31469-6.
[13]	汪仕良. 烧伤后能量代谢[M]//汪仕良, 邓诗琳. 烧(创)伤代谢营养的理论和实践. 石家庄: 河北科学技术出版社, 2014: 130-135.
[14]	黄跃生, 黎鳌. 烧伤的临床过程[M]//杨宗城. 烧伤治疗学. 3版. 北京: 人民卫生出版社, 2006: 72-74.
[15]	MooreFD. Metabolic care of the surgical patient[M]. Philadelphia and London: W. B. Saunders Company, 1959: 868-917.
[16]	ZhangY,CaiB,JiangH,et al.Use of 1H-nuclear magnetic resonance to screen a set of biomarkers for monitoring metabolic disturbances in severe burn patients[J].Crit Care,2014,18(4):R159.DOI: 10.1186/cc13999.
[17]	张勇烧伤代谢指纹图谱绘制、代谢靶标筛选及营养治疗方案优化的研究重庆第三军医大学2014 张勇. 烧伤代谢指纹图谱绘制、代谢靶标筛选及营养治疗方案优化的研究[D]. 重庆: 第三军医大学, 2014.
[18]	JeschkeMG,GauglitzGG,KulpGA,et al.Long-term persistance of the pathophysiologic response to severe burn injury[J].PLoS One,2011,6(7):e21245.DOI: 10.1371/journal.pone.0021245.
[19]	刘琰,王际壮.烧伤应激反应及其调控策略[J].中华烧伤杂志,2021,37(2):126-130.DOI: 10.3760/cma.j.cn501120-20201125-00499.
[20]	邓虎平, 蔡建华, 柴家科, 等. 腺苷一磷酸活化蛋白激酶在严重烫伤大鼠骨骼肌萎缩中的作用[J]. 中华烧伤杂志, 2021, 37(7): 640-646. DOI: 10.3760/cma.j.cn501120-20200416-00227.
[21]	ArabiYM, Al-DorziHM. Trophic or full nutritional support?[J]. Curr Opin Crit Care, 2018, 24(4): 262-268.DOI: 10.1097/MCC.0000000000000508.
[22]	彭曦.重视谷氨酰胺在烧伤临床的规范应用[J].肠外与肠内营养,2021,28(1):1-4.
[23]	PengX, WangKF, ZhangY, et al. Establishment and assessment of new formulas for energy consumption estimation in Chinese adult burn patients[J]. PLoS One,2014,9(10):e110409.DOI: 10.1371/journal.pone.0110409.
[24]	HartlWH,JauchKW.Metabolic self-destruction in critically ill patients: origins, mechanisms and therapeutic principles[J].Nutrition,2014,30(3):261-267.DOI: 10.1016/j.nut.2013.07.019.
[25]	SheriffS,KadeerN,FriendLA,et al.Des-acyl-ghrelin (DAG) normalizes hyperlactacidemia and improves survival in a lethal rat model of burn trauma[J].Peptides,2014,60:1-7.DOI: 10.1016/j.peptides.2014.07.010.
[26]	NordlundMJ,PhamTN,GibranNS.Micronutrients after burn injury: a review[J].J Burn Care Res,2014,35(2):121-133.DOI: 10.1097/BCR.0b013e318290110b.
[27]	RussellMK,WischmeyerPE.Supplemental parenteral nutrition: review of the literature and current nutrition guidelines[J].Nutr Clin Pract,2018,33(3):359-369.DOI: 10.1002/ncp.10096.
[28]	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.
[29]	龚翔,谢卫国.烧伤后骨代谢异常[J].中华烧伤杂志,2016,32(8):502-504.DOI: 10.3760/cma.j.issn.1009-2587.2016.08.015.
[30]	AdjepongM,AgbenorkuP,BrownP,et al.The role of antioxidant micronutrients in the rate of recovery of burn patients: a systematic review[J/OL].Burns Trauma,2016,4:18[2021-08-02].https://pubmed.ncbi.nlm.nih.gov/27574687/. DOI: 10.1186/s41038-016-0044-x.
[31]	EndoY,NourmahnadA,SinhaI.Optimizing skeletal muscle anabolic response to resistance training in aging[J].Front Physiol,2020,11:874.DOI: 10.3389/fphys.2020.00874.
[32]	PrelackK,YuYM,SheridanRL.Nutrition and metabolism in the rehabilitative phase of recovery in burn children: a review of clinical and research findings in a speciality pediatric burn hospital[J/OL].Burns Trauma,2015,3:7[2021-08-02].https://pubmed.ncbi.nlm.nih.gov/27574653/. DOI: 10.1186/s41038-015-0004-x.
[33]	SommerhalderC,BlearsE,MurtonAJ,et al.Current problems in burn hypermetabolism[J].Curr Probl Surg,2020,57(1):100709.DOI: 10.1016/j.cpsurg.2019.100709.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Get Citation

PDF

XML

Article Metrics

Article views (2647) PDF downloads(114)

Metabolic staging and nutritional treatment strategies of severely burned patients

doi: 10.3760/cma.j.cn501120-20210802-00264

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Metabolic staging and nutritional treatment strategies of severely burned patients

doi: 10.3760/cma.j.cn501120-20210802-00264

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content