Effects of Nutritional Supplementation on Prealbumin Concentrations in Pediatric Burn Patients: A Randomized, Controlled Trial
Jennifer A. Williams*, 1, Anna Yankina2, Yong S. Choe1, Lyudmila Dokukina3, Marina Brazol4, Evgeniy Altshuler5, Mikhail Gordon6, Nikolay Ostrovskiy7, Evgeniy Kuraev8, Barbara J. Marriage1
Identifiers and Pagination:Year: 2013
First Page: 20
Last Page: 25
Publisher Id: TONUTRJ-7-20
Article History:Received Date: 28/08/2013
Revision Received Date: 02/10/2013
Acceptance Date: 02/10/2013
Electronic publication date: 18/10/2013
Collection year: 2013
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This prospective, randomized study was designed to measure the effect of nutritional supplementation on serum prealbumin (transthyretin) in pediatric burn patients in seven burn centers in Russia. The primary measure was change in serum prealbumin from baseline to Day 7.
Fifty-four children age 1-10 years with a TBSA burn of at least 15% were enrolled into this study. Patients had baseline serum prealbumin levels > 10 mg/dL and were capable of exclusive oral feeding within 72 hours of hospitalization. One-hundred-sixteen children were screened, with 54 meeting eligibility criteria, 28 subjects in the control group and 26 in the supplement group. Patients were randomized to receive the typical hospital diet for mild to moderate burn patients or the same diet plus additional oral nutritional supplementation. The additional enteral supplementation was 299 kcal/day for most of the subjects.
Nutritional supplementation significantly increased serum prealbumin levels of the subjects from baseline to Day 7. At Day 7, children consuming the supplementation had a mean ± standard error change in prealbumin concentration of 8.44 ± 1.13 mg/dL and children on hospital diet only had a change of 5.47 ± 0.80 mg/dL, with a difference of 2.97 mg/dL (p=0.0265). There were no significant differences in baseline serum prealbumin concentration, nor were there differences for adverse events or safety concerns related to study product.
The increase of prealbumin related to enteral supplementation may provide future guidance for nutritional management of pediatric burn patients or patients with increased energy and protein needs.