Prospective Controlled Trial to Compare Immune-Enhancing and Regular Enteral Diets to Reduce Septic Complication in Major Burn Patients
Watcharade Iamsirisaengthong MD*, Kusuma Chinaroonchai MD*, Chomchak Chuntrasakul MD*, Somphon Roeksomtawin MD*, Pornprom Muangman MD*
Affiliation : * Division of Trauma Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Many studies reported the benefit of glutamine and arginine rich enteral diet or immune-enhancing enteral diet
in reduction of the septic complication in trauma patients. However most of the studied subjects were trauma, not burn
patients. Many physiologic changes after injury in burn patients quite alike other types of trauma patients, so that many but
not all changes in trauma patients can be applied to burn patients. In addition, septic complication in burn patients had some
differences in pathophysiology when compared to general trauma patients such as the consequence burn wound infection as
a wound complication or the respiratory tract malfunction sequelae from inhalation injury, etc.
Objective : To demonstrate the benefit of immune-enhancing enteral diet in reduction of septic complication in major burn
patients.
Material and Method: A prospective randomized controlled trial was conducted in 20 major burn patients.
Results : No statistically significant difference in septic complications (p = 0.370) and mortality rate (p>0.05) between both
groups was observed. However, immune-enhancing diet group showed advantage in increasing in bodyweight (p = 0.010),
albumin level (p = 0.005) and transferrin level (p<0.001).
Conclusion : Immune-enhancing diet may demonstrated trend of decreasing in septic complications and the significance in
maintaining body weight and increasing in albumin and transferrin level in major burn patients.
Keywords : Glutamine, Arginine, Enteral diet, Septic complication, Burn
