The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

COMPARISON OF RESTING ENERGY EXPENDITURE IN SEVERELY BURNED CHILDREN VS NON-BURN CONTROLS AT 24 MONTHS POST-BURN

Ronald P. Mlcak, PhD, RRT, FAARC, Oscar E Suman, PhD,  Marc G Jeschke, PhD, MD, David N Herndon, MD. Shriners Hospital for Children, Galveston, Texas and The University of Texas Medical Branch, Galveston, Texas

Introduction: The hypermetabolic response to severe burn trauma is associated with increased resting energy expenditure (REE) and catabolism, which is known to persist for up to 12 months post-burn. However, we have evidence that this burn induced elevated REE persist longer than 12 months. The purpose of this study was to compare REE in a group of severely burned children to normal non-burn controls at 24 months post-burn.

Methods: Fifty-five children were enrolled in this prospective study. Forty-two patients with > 40% TBSA burn were compared to 13 healthy non-burn controls. REE was measured by indirect calorimetry and compared to predicted values according to the Harris-Benedict equation. Data were collected at 24 months post-burn when the patients returned for out-patient surgery. Both groups of patients were studied in a fasted state and in similar environmental conditions. A p<0.05 was accepted as statistically significant.

Results: Mean TBSA burned was 63±16 % and mean age was 9±4 years in the burn group. In the control group the mean age was 13±2 years with no history of a burn injury. The measured REE was 1272 kcal/day (range 740-1986) in the burn group vs. 1446 kcal/day (range 838-2119) in the non-burn group (p=0.14). The mean % of predicted REE in the burn group was 100% (range 46-151) compared to 88% (range 61-108) in the non-burned group (p<0.03). Seventy-five percent of the patients in the burn group had a % predicted REE >92% compared to 39% of the children in the non-burned group (p<0.05).

Conclusion: In some severely burned children, REE remains elevated above predicted levels for 24 months post-burn. We suggest that these patients need to be further characterized and identified in order to initiate early treatment to effectively attenuate hypermetabolism.

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