A major burn can impair the barrier function of the gut. This leads to an increase in bacterial - particularly gram negative organisms - translocation into the blood. Hence, there is a greater tendency to a systemic inflammatory response syndrome (SIRS). This can be minimised with early nutritional supplementation via the gut - see submenu.
Severe burns may increase the risk of acute gastric ulceration. Previously this was a cause of upper gastrointestinal tract haemorrhage with a high mortality rate. This complication can be minimised by the prophylactic use of a hydrogen receptor antagonist such as cimetidine or ranitidine.
Finally, burns can lead to an intestinal ileus. This tends to occur if fluid resuscitation is delayed. If this is the case, a nasogastric tube may be required to reduce the risk of vomiting and aspiration. However, as there is evidence that the ileus is resolving, feeding should commence.
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