Influence of Inhalation Injury on Resting Energy Expenditure in Severely Burned Children

Extract

Introduction:

The metabolic response to stress leads to the release of catecholamine, glucagon and cortisol causing a severe catabolic reaction and increases in energy expenditure. A correlation between burn size and metabolic rate has been well established. However, the presence of an inhalation injury, in addition to a severe burn, has not been well-recognized as increasing the hypermetabolic stress response. The purpose of this study was to assess the influence of inhalation injury on resting energy expenditure in the severely burned pediatric population.

Methods:

A total of 102 severely burned children with total body surface area burns ≥ 40%, between 1 to 18 years of age, were assigned to one of two groups: inhalation injury or no inhalation injury based on bronchoscopic evaluation. Patients that did not survive through their acute hospitalization were dropped from this study. Indirect calorimetry was performed at the bedside between midnight and 0500 at admission, at the height of the hypermetabolic response and again at discharge. Study variables include measured resting energy expenditure (MREE), % of predicted REE and oxygen consumption (VO₂). Data are presented as mean ± standard error of the mean (SEM). Significance was accepted at p < 0.05 using an unpaired t-test.