Supplemental enteral glutamine does not reduce the time to discharge alive from the hospital among patients with severe burns, according to a study published the New England Journal of Medicine. Daren K. Heyland, MD, and colleagues, conducted a double-blind, randomized, placebo-controlled trial of patients with deep second- or third-degree burns within 72 hours after hospital admission. Participants with severe burns (mean burn size, 33% of total body surface area) received 0.5 g/kg of body weight per day of enterally delivered glutamine or placebo (596 and 604 participants, respectively). Trial agents were given every 4 hours through a feeding tube or three or four times per day by mouth. The median times to discharge alive from the hospital were 40 days in the glutamine group and 38 days in the placebo group (sub-distribution HR for discharge
alive, 0.91). At 6 months, mortality rates were 17.2% and 16.2% in the glutamine and placebo groups, respectively (HR for death, 1.06).
Considerably More Surgeries for Burn Injury Pre-Pandemic
Independent of burn severity, the probability of undergoing burn excision or grafting was considerably lower for patients during the COVID-19 pandemic, according to a study published in Burns. As a result, the adjusted risk for mortality was higher among patients, explained Jared Gallaher, MD, MPH, and colleagues, who conducted a retrospective analysis of patients with burn injury who were treated in a tertiary hospital during
2011-2021. The study team compared patients based on whether they presented for surgery pre- or intra pandemic. Modified Poisson modeling was utilized to estimate the adjusted risk of undergoing an operation and the risk for mortality. A total of 2,969 patients, with 390 presenting during the pandemic, were included. During the pre-pandemic period, more patients underwent surgery, but crude mortality rates were similar, at 17.3% vs. 21.2%. The risk ratio (RR) for surgery during the pandemic was 0.45, adjusted for age, sex, flame burns, time to presentation, and percent total body surface area (TBSA). The RR for in-hospital mortality during the pandemic was 1.23, adjusted for age, sex, percent TBSA, flame burns, time to presentation, and surgical intervention.
