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

作　　者：David R.Schieffelers Eric van Breda Nick Gebruers Jill Meirte Ulrike Van Daele 

机构地区：[1]Multidisciplinary Metabolic Research Unit(M2RUN),MOVANT Research Group,Department of Rehabilitation Sciences and Physiotherapy,Faculty of Medicine and Health Sciences,University of Antwerp,Universiteitsplein 1,2610,Wilrijk,Antwerp,Belgium [2]Multidisciplinary Edema Clinic,Antwerp University Hospital,Wilrijkstraat 10,2650,Edegem,Antwerp,Belgium [3]OSCARE,Organisation for burns,scar after-care and research,Van Roiestraat 18,2170 Merksem,Antwerp,Belgium

出　　处：《Burns & Trauma》2021年第1期613-628,共16页烧伤与创伤（英文）

基　　金：DRS is funded through a doctoral fellowship by the Research Foundation Flanders(FWO)[11B8619N].

摘　　要：Background:Hypermetabolism,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.Methods:An 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.Results:Fifty-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 bu

关 键 词：Burn care Burn rehabilitation Exercise Early mobilization HYPERMETABOLISM ADULTS 

分 类 号：H31[语言文字—英语]