Early enteral feeding of a severely burned pediatric patient.

Early postburn duodenal feeding can provide adequate nutritional support despite increased risk of intolerance in a severely injured pediatric patient. A 3-year-old girl was admitted with 30% total body surface area thermal burns and sever inhalation injury. During admission, a pediatric feeding tube was placed into the duodenum, and enteral feeding was initiated within 12 hours after injury. Total enteral feeding provided full nutritional needs by postburn day 5 and continued to provide stable and adequate nutrition throughout administration. A full-strength isotonic formula with high concentration of dipeptides and tripeptides was used. Complications of enteral feeding did not prevent achievement of positive caloric and protein balance or repletion of nutritional stores with conscientious nutritional management. Maintenance of admission weight was achieved. This case report describes techniques in nutritional monitoring to assist in optimizing enteral nutrition management.