Early Enteral Nutrition Does Not Decrease Hypermetabolism Associated with Burn Injury

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Abstract
A prospective, randomized study was performed to compare the effects of early versus late enteral feeding on postburn metabolism. Burn patients were randomized to receive enteral feedings either within 24 hours (early) or 7 days (late) of injury. Basal energy expenditure (BEE) was calculated from Harris-Benedict equations and resting energy expenditure (REE) was obtained from indirect calorimetry. The average daily energy expenditure (DEE) was expressed as REE/BEE. Average age, burn size, infections, and length of stay were similar between groups. Mortality between groups was similar (early, 28%; late, 38%) and not significantly influenced by inhalation injury. When controlled for percentage of total body surface area burn, inhalation injury, and age, the early group had an increased rather than decreased DEE, with a mean DEE calorie 0.17 more than the late group (p = 0.07). Early enteral feeding does not decrease the average energy expenditure associated with burn injury.