This study was performed to investigate the mechanism whereby immediate enteral feeding after burn injury reduces postburn hypermetabolism and hypercatabolism. Fifty-seven burned guinea pigs (30% TBSA) were divided into three groups: A (N = 19), given 175 kcal/kg/day beginning 2 hours after burn; B (N = 20), given 175 kcal/kg/day with an initial 72-hour adaptation period; and C (N = 18), given 200 kcal/kg/day with the same adaptation period as B. Resting metabolic expenditure (RME) on PBD 13 was lowest in group A (109% of preburn level), compared with group B (144%, p less than 0.001) and group C (137%, p less than 0.01). On PBD 1, group A had the greatest jejunal mucosal weight and thickness (p less than 0.001), and mucosal weight had negative correlations with plasma cortisol (r = 0.829, p less than 0.001) and glucagon (r = 0.888, p less than 0.001). Two weeks after burn, urinary vanillyl mandelic acid (VMA) excretion, plasma cortisol, and glucagon were lowest in group A (p less than 0.05 to p less than 0.01). These hormones also significantly correlated with RME (p less than 0.01 to p less than 0.001). These findings suggest that immediate postburn enteral feeding can prevent hypermetabolism via preservation of gut mucosal integrity and prevention of excessive secretion of catabolic hormones.
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机译：进行这项研究以研究烧伤后立即肠内进食减少烧伤后新陈代谢和代谢亢进的机制。将五十七只豚鼠（30％TBSA）烧伤分为三组：A（N = 19），烧伤后2小时开始给予175 kcal / kg /天； B（N = 20），给定为175 kcal / kg /天，初始适应时间为72小时；和C（N = 18），每天200 kcal / kg / kg，适应期与B相同。与B组相比，PBD 13上的静止代谢支出（RME）在A组中最低（预烧水平的109％）。 144％，p小于0.001）和C组（137％，p小于0.01）。在PBD 1上，A组的空肠黏膜重量和厚度最大（p小于0.001），且黏膜重量与血浆皮质醇（r = 0.829，p小于0.001）和胰高血糖素（r = 0.888，p小于0.05）呈负相关。 0.001）。烧伤后两周，A组尿香草兰扁桃酸（VMA）排泄，血浆皮质醇和胰高血糖素最低（p小于0.05至p小于0.01）。这些激素也与RME显着相关（p小于0.01至p小于0.001）。这些发现表明，立即烧伤后肠内喂养可通过保留肠道粘膜完整性和防止分解代谢激素的过度分泌来预防代谢亢进。
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