74 Implications of Pre-Operative Ng Fasting on Nutrition in Major Burn Patients: An Audit of Practice

Abstract

Background Nasogastric (NG) feeding is commonly employed as a first line method of enteral feeding. This needs to be stopped pre-operatively resulting in missed calories and protein. Nasojejunal (NJ) feeding is an alternative method that can continue during surgery and can be used in gastric stasis. In this audit we want to determine the calorie and protein loss in major burns patients at the Northern Regional Burn Centre who have had enteral feeding via the nasogastric route. Method A retrospective analysis of the NG feeding, and fasting times was carried out for major burns patients at the Royal Victoria Infirmary in Newcastle from 2019 to 2021. Nine patients were identified, and their NG feeding prescriptions and delivery times were looked at. The number of calories and protein prescribed by the dietitian were compared against the amount missed when the NG feed was paused. A percentage loss was calculated for each parameter. Results Of the 9 patients analysed over 3 years, the calories lost ranged from 2226kcal to 23,929kcal. Of the induvial prescribed calorie intake, the calorie loss was from 7% to 39% with a mean calorie loss of 17.6%. The protein lost ranged from 143g to 1,240g. Of the individual prescribed protein intake, the protein loss was from 7% to 40% with a mean protein loss of 19.4%. Conclusions We recommend that the addition of NJ feeding as an alternative method of enteral feeding to the NUTH burns nutritional policy would help optimise the management of major burns patients by minimising nutritional losses.