Nutrition support in burn injury

Nutrition assessment of the thermally injured patient requires a multifactorial approach and ongoing reassessment due to the dynamic nature of the recovery process. A thorough nutrition assessment and ongoing monitoring are crucial to achieve the goal of mitigating the metabolic response, preserving lean body mass (LBM) and preventing protein‐energy undernutrition. Initial assessment should involve standard nutritional indicators, including anthropometrics, biochemical markers, clinical status and dietary history, with a focus on severity of burn injury and haemodynamic status. Clinical factors, including burn size and severity, resultant metabolic response, timing of excision and grafting, use of occlusive wound dressing and haemodynamic stability, provide the foundation for initial nutrition assessment. Enteral nutrition (EN) is well established as the preferred route of nutrition support in patients with severe burns. Early initiation of EN and ongoing, accurate nutritional assessment are crucial to meet increased requirements, attenuate the hypermetabolic response, and prevent LBM loss and undernutrition.