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.