Nutritional therapy based on positive caloric balance in burn patients.

Oxygen consumption and caloric expenditure was 1 1/2 to 2 times normal in 15 major burn patients from the time of burn to the time of surface coverage. This hypermetabolic state was quite consistent hour-to-hour and day-to-day, and correlated best with the extent of full-thickness burn. Nutritional management and caloric intake can be intelligently planned using simple spirometry and indirect calorimetry to measure caloric requirements. Weight gain and prompt healing can be achieved by positive caloric balance. Based on daily metabolic studies, a positive caloric balance feeding protocol has been used in the treatment of 556 patients. This regimen, in combination with many other factors in physiologic and surface care, has resulted in high survival rates, short hospitalization, and rapid rehabilitation.