Strategies for preventing gastrointestinal complications in severely burned patients

Gastrointestinal dysfunction is a common complication of severe burns. Injury to GI function, especially to GI barrier function, is an important initiator as well as a stimulator for occurrence of systemic inflammatory response syndrome, sepsis and multiple organ dysfunction syndrome following severe burns. With the deeper understanding of GI function and changes in the stereotype of clinical treatment in recent 30 years, a series of new therapies including fluid resuscitation, early escharectomy, continuous renal replacement therapy, and use of glutamine and growth factor has been adopted in the treatment of severe burns. Although animal experiments available have shown that these new therapies do play a positive role in the prevention and treatment of GI dysfunction following severe burns, there has been a lack of convincing clinical data to confirm the outcome.

A rapid communication to be published in 28 May 2008, in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Xia Zhaofan from Department of Burn Surgery, Changhai Hospital, Second Military Medical University,China. The study reviewed the clinical data of 219 patients with large area burns in recent more than 20 years, who were classified into different stages according to the therapeutic protocols used at the time, based on which the outcomes of GI function prevention and treatment were compared, analyzed and summarized in an attempt to propose some practicable guidelines for the effective prevention and treatment of GI dysfunction.

The researchers observed that comprehensive fluid resuscitation, early excision of necrotic tissue, staged food ingestion, and administration of specific nutrients were essential strategies of preventing gastrointestinal complications and lowering mortality in severe burn patients. Some experts said it is really valuable to see the actual results from changes in therapies of gastrointestinal dysfunction following severe burns over the last 30 years.

Reference:, Zhu SH, Xia ZF, Lu W, Wang GQ, Ben DF, WangGY, Cheng DS. Prevention treatment of gastrointestinal dysfunction following severe burns: A summary of recent 30-year clinical experience. World J Gastroenterol 2008;14(20): 3231-3235
http://www.wjgnet.com/1007-9327/14/3231.asp

Correspondence to: Zhao-Fan Xia, MD, PhD, Department of Burn Surgery, Changhai Hospital, Second Military Medical University, 174 Changhai Road, Shanghai 200433, China. xiazhaofan@hotmail.com
Telephone: +86-21-25070599 Fax: +86-21-65589829

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.