Influence of inhalation injury on energy expenditure in severely burned children

• Published in: Burns 2014-12, Vol.40 (8), p.1487-1491
• Main Authors: Przkora, Rene, Fram, Ricki Y, Herndon, David N, Suman, Oscar E, Mlcak, Ronald P
• Format: Article
• Language: English
• Subjects: Adolescent; Basal Metabolism; Bronchoscopy; Burns; Burns - complications; Burns - metabolism; Burns, Inhalation - complications; Burns, Inhalation - diagnosis; Burns, Inhalation - metabolism; Calorimetry, Indirect; Case-Control Studies; Child; Child, Preschool; Critical Care; Energy Metabolism; Female; Humans; Hypermetabolism; Indirect calorimetry; Infant; Inhalation injury; Male; Oxygen Consumption; Prospective Studies; Resting energy expenditure; Trauma Severity Indices
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2014.04.019

Abstract Objective Determine the effect of inhalation injury on burn-induced hypermetabolism in children. Design Prospective study comparing hypermetabolism (i.e., resting energy expenditure and oxygen consumption) in burned children with and without inhalation injury during acute hospitalization. Setting Single pediatric burn center. Patients Eighty-six children (1–18 years) with ≥40% total body surface area burns were stratified to two groups: no inhalation injury and inhalation injury. Interventions None. Main measurements and results Inhalation injury was diagnosed based on bronchoscopic evaluation. At admission, PaO2 :FiO2 ratios (an index of respiratory distress) were significantly higher in patients with no inhalation injury than in patients with inhalation injury. No differences were detected in resting energy expenditure or percent of the predicted basal metabolic rate between groups. Additionally, oxygen consumption did not significantly differ between groups. Conclusions Inhalation injury does not augment the burn-induced hypermetabolic stress response in children, as reflected by resting energy expenditure and oxygen consumption.