Define Protein needs in Nutrient Requirement and Dietary Management?
It is one of the most crucial nutrient which determines the ultimate outcome of burns. Amino acid requirements are high due to increased losses through wounds and urine, increased requirement for promoting synthesis of blood proteins and wounds. Fluid loss from a burn wound may be considerable and can contain 4-6 g protein/100 ml, representing 25-50'33 of total nitrogen loss. Nitrogen losses via faeces have been estimated to be around 1-3g N/day. Thus, adult patients should be given = 20-25% of the increased energy from protein.
Among children the requirements are still higher i.e. 2.5 to 3.0 g per kg usual body weight per day. Protein intake beyond this level is not recommended in view of the increased burden on the kidneys. Blood urea nitrogen, serum creatinine and level of hydration must be monitored carefully. The protein intake may need to be curtailed if the burnt area has involved the kidney / excretory system. High biological value protein food sources such as eggs, milk, cheese, yogliurt, marine food, meat, poultry, legumes and pulses should be included liberally but in an easy to digest form. Hospital based tube feeds may be prepared by using soya milk, milk proteins (casein, whey protein, lactalbumin), eggs and flour of pulses particularly soyabean.