الفهرس | Only 14 pages are availabe for public view |
Abstract Extensive burn doesn’t cause only a cutaneous injury, but also systemic changes associated with serious pathophysiological complications. The gut is not a passive organ in the patients who suffers a major thermal injury. The intestinal tract has important nutritional and barrier function and aberrations of these functions in the critically ill burn patients may contribute significantly to morbidity and mortality. Manifestation of GIT dysfunction in burn patients can be categorized by location, those related to the foregut include parotitis, dysphagia, oesophageal erosions, gastrodudenal ulcer disease, acalculous cholecystitis, vomiting and gastric dilatation, those related to midgut include ileus, diarrhea, superior mesenteric artery syndrome, intestinal ischemia and protein losing enteropathy, those related to hindgut include non obstructive colonic dilatation, pseudo membranous colitis and lower GIT bleeding and those related to solid organs include hepatic dysfunction, intrahepatic cholestasis, disturbance in fat-soluble vitamins, fatty liver and hepatic acute phase response, hepatic failure and acute pancreatitis. Patients whose burns are extensive (greater than 30% TBSA) require intensive nutritional support until their wounds heal completely. A wide variety and number of published regimens for providing nutrients are available. Use enteral nutrition whenever possible, and serve TPN for patients with concomitant abdominal trauma, refractory ileus, or other complications that render GIT unusable must be the role. |