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THE   BURN   NUTRITION   MODULE

Robert H. Demling, M.D. Leslie DeSanti R.N.Dennis P. Orgill, M.D. PhD.

Section  III

WHAT ARE THE PROTEIN NEEDS?

Recommended Intake

Adult : 1.5-2g/kg/day*

Child: 2-2.5g/kg/day*

* Based On Metabolic Studies


ASSESSMENT

  • nitrogen intake minus nitrogen loss (urine)

  • wound healing rate

  • body strength

  • degree of weight loss
  • lean mass loss

Protein requirements are much harder to define on an individual basis as there is not a readily available method of determining the rate of protein synthesis. Protein loss can be monitored in the urine as nitrogen excretion which can then be converted to protein loss. However, this does not define any protein synthesis or gain. A number of excellent clinical studies using complex technology has defined burn patient protein requirements as a population (adult and pediatric). Fine tuning can be performed, based on standard clinical and biochemical tests.

The standard requirements, presented have been adopted as the standard of care. Adult protein intake should be between 1.5-2 grams/kg/day and children need 2-2.5gram/kg/day. Protein or nutrient supplements are invariable needed to reach this goal. Adding specific amino acids glutamine and to a lesser extent arginine have been reported to be of benefit when provided with the necessary protein.


 

 


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