Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?

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Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?

更新时间：2022-06-14

- Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?
- Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?
- Burns & Trauma 2021年9卷第1期
- 作者机构：
  
  1. Multidisciplinary Metabolic Research Unit (M2RUN)
  2. University of Antwerp
  3. Multidisciplinary Edema Clinic, Antwerp University Hospital
  4. OSCARE, Organisation for burns, scar after-care and research
- 作者简介：
- 基金信息：
  
  DRS is funded through a doctoral fellowship by the Research Foundation Flanders (FWO) [11B8619N].
- DOI：10.1093/burnst/tkaa039
  中图分类号：
- 纸质出版日期：2021，
  
  网络出版日期：2021-3-1，
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David R Schieffelers, Eric van Breda, Nick Gebruers, 等. Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?[J]. Burns & Trauma, 2021,9(1).

David R Schieffelers, Eric van Breda, Nick Gebruers, Jill Meirte, Ulrike Van Daele, Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?, Burns & Trauma, Volume 9, 2021, tkaa039, https://doi.org/10.1093/burnst/tkaa039
David R Schieffelers, Eric van Breda, Nick Gebruers, 等. Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?[J]. Burns & Trauma, 2021,9(1). DOI： 10.1093/burnst/tkaa039.

David R Schieffelers, Eric van Breda, Nick Gebruers, Jill Meirte, Ulrike Van Daele, Status of adult inpatient burn rehabilitation in Europe: are we neglecting metabolic outcomes?, Burns & Trauma, Volume 9, 2021, tkaa039, https://doi.org/10.1093/burnst/tkaa039 DOI：

摘要

Abstract

BackgroundHypermetabolism

muscle wasting and insulin resistance are challenging yet important rehabilitation targets in the management of burns. In the absence of concrete practice guidelines

however

it remains unclear how these metabolic targets are currently managed. This study aimed to describe the current practice of inpatient rehabilitation across Europe.MethodsAn electronic survey was distributed by the European Burn Association to burn centres throughout Europe

comprising generic and profession-specific questions directed at therapists

medical doctors and dieticians. Questions concerned exercise prescription

metabolic management and treatment priorities

motivation and knowledge of burn-induced metabolic sequelae. Odds ratios were computed to analyse associations between data derived from the responses of treatment priorities and knowledge of burn-induced metabolic sequelae.ResultsFifty-nine clinicians with 12.3 ± 9 years of professional experience in burns

representing 18 out of 91 burn centres (response rate

19.8%) across eight European countries responded. Resistance and aerobic exercises were only provided by 42% and 38% of therapists to intubated patients

87% and 65% once out-of-bed mobility was possible and 97% and 83% once patients were able to leave their hospital room

respectively. The assessment of resting energy expenditure by indirect calorimetry

muscle wasting and insulin resistance was carried out by only 40.7%

15.3% and 7.4% respondents

respectively

with large variability in employed frequency and methods. Not all clinicians changed their care in cases of hypermetabolism (59.3%)

muscle wasting (70.4%) or insulin resistance (44.4%)

and large variations in management strategies were reported. Significant interdisciplinary variation was present in treatment goal importance ratings

motivation and knowledge of burn-induced metabolic sequelae. The prevention of metabolic sequelae was regarded as the least important treatment goal

while the restoration of functional status was rated as the most important. Knowledge of burn-induced metabolic sequelae was linked to higher importance ratings of metabolic sequelae as a therapy goal (odds ratio

4.63; 95% CI

1.50–14.25; p < 0.01).ConclusionThis survey reveals considerable non-uniformity around multiple aspects of inpatient rehabilitation across European burn care

including

most notably

a potential neglect of metabolic outcomes. The results contribute to the necessary groundwork to formulate practice guidelines for inpatient burn rehabilitation.

关键词

Keywords

Burn careBurn rehabilitationExerciseEarly mobilizationHypermetabolismAdults

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