High-Carbohydrate vs High-Fat Nutrition for Burn Patients

Abstract

Nutrition is an essential component of the healing and recovery process after severe burn injury. For many burn patients, nutrition support is necessary to meet nutrition goals. The ratio of carbohydrates and fat is particularly important for burn patients, as an essential fatty acid deficiency can contribute to poor wound healing. However, there is evidence to suggest that diets containing more carbohydrates and less fat may result in better patient outcomes. A literature search was conducted to identify studies related to nutrition support and macronutrient ratios in burn patients. Eleven published papers were found that considered macronutrient use in enteral and parenteral nutrition therapies among 9 different burn patient samples. No negative outcomes associated with lower fat, higher carbohydrate nutrition for severely burned patients were found in the literature. Conversely, the literature review revealed improved outcomes among severely burned patients receiving lower fat, higher carbohydrate nutrition to include fewer incidences of pneumonia, wound infections, acute respiratory distress syndrome, fatty liver, and sepsis. These patients also experienced shorter hospital length of stay and shorter wound healing times, as well as lower spleen and kidney weights, lower urinary nitrogen losses, improved nitrogen balance, higher insulin levels, higher insulin-like growth factor-1, lower cortisol, and less muscle protein breakdown. The evidence available to date supports the clinical use of nutrition support providing ≤15% fat and ≥60% carbohydrate for critically ill burn patients.

Keywords: burns; carbohydrates; complications; critical illness; fats; length of stay; nutrition support.