Association between dietary fat content and outcomes in pediatric burn patients.
Study Goal
The researchers aimed to compare the clinical outcomes of a low-fat/high-carbohydrate diet versus a high-fat diet in pediatric burn patients.
Results Summary
The high-fat diet group had longer ICU stays, higher sepsis incidence, shorter survival until death, and increased hepatic steatosis and organomegaly compared to the low-fat/high-carbohydrate group, though overall mortality did not differ.
Population
Children with burns ≥ 40% of total body surface area (TBSA).
Effective Dosage
Not specified (milk as high-fat diet vs. Vivonex T.E.N. as low-fat/high-carbohydrate diet).
Duration
Not explicitly stated (followed until death or discharge).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | decrease | ICU stays | children with burns ≥ 40% of their total body surface area | 31 ± 2 d (vs 47 ± 2 d for milk) | had shorter | #1 |
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | decrease | ICU stay per % TBSA burn | children with burns ≥ 40% of their total body surface area | 0.51 ± 0.02 d/% (vs 0.77 ± 0.03 d/% for milk) | had shorter | #2 |
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | decrease | sepsis | children with burns ≥ 40% of their total body surface area | 11% (vs 20% for milk) | lower incidence of | #3 |
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | increase | time until death | children with burns ≥ 40% of their total body surface area | 20 ± 3 d (vs 10 ± 2 d for milk) | lived significantly longer until death than | #4 |
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | no change | overall mortality | children with burns ≥ 40% of their total body surface area | 15% versus 13% | no difference in | #5 |
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | decrease | hepatic steatosis | children with burns ≥ 40% of their total body surface area | - | decreased | #6 |
low-fat/high-carbohydrate diet (Vivonex T.E.N.) | decrease | enlargement of kidney and spleen | children with burns ≥ 40% of their total body surface area | - | decreased | #7 |
low-fat/high-carbohydrate diet | decrease | length of stay (LOS) | patients post-burn | - | associated with lower | #8 |
low-fat/high-carbohydrate diet | decrease | organomegaly | patients post-burn | - | associated with decreased incidence of | #9 |
low-fat/high-carbohydrate diet | decrease | infection | patients post-burn | - | associated with decreased incidence of | #10 |
low-fat/high-carbohydrate diet | decrease | hepatic steatosis | patients post-burn | - | associated with decreased incidence of | #11 |
high-fat diet | neutral | clinical outcomes | - | - | associated with poorer outcomes compared with | #12 |
BACKGROUND: The aim of the study was to compare a low fat/high-carbohydrate diet and a high-fat diet on clinical outcomes by a retrospective cohort study. METHODS: Nine hundred forty-four children with burns ≥ 40% of their total body surface area (TBSA) were divided into two groups: patients receiving Vivonex T.E.N. (low-fat/high-carbohydrate diet; n = 518) and patients receiving milk (high-fat diet; n = 426). Patient demographics, caloric intake, length of hospital stay, and incidence of sepsis, mortality, hepatic steatosis, and organomegaly at autopsy were determined. RESULTS: Demographics and caloric intake were similar in both groups. Patients receiving Vivonex T.E.N. had shorter (intensive care unit) ICU stays (Vivonex T.E.N.: 31 ± 2 d; milk: 47 ± 2 d; P < 0.01), shorter ICU stay per % TBSA burn (Vivonex T.E.N.: 0.51 ± 0.02 d/%; milk: 0.77 ± 0.03 d/%; P < 0.01), lower incidence of sepsis (Vivonex T.E.N.: 11%; milk: 20%; P < 0.01), and lived significantly longer until death than those receiving milk (Vivonex T.E.N.: 20 ± 3 d; milk: 10 ± 2 d; P < 0.01). There was no difference in overall mortality between the two groups (Vivonex T.E.N.:15% versus milk: 13%; P < 0.9). Autopsies revealed decreased hepatic steatosis and decreased enlargement of kidney and spleen in patients receiving Vivonex T.E.N. CONCLUSIONS: The period with a low-fat/high-carbohydrate diet was associated with lower LOS, decreased incidence of organomegaly, infection, and hepatic steatosis post-burn compared with the period when a high-fat diet was used. These associations indicate the benefit of high carbohydrate/low fat nutrition; however, the findings in these time periods can also be likely due to the multifactorial effects of advances in burn care. We believe that these results have some relevance because high fat is associated with poorer outcomes compared with low fat.