Influence of inhalation injury on energy expenditure in severely burned children

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Study examined the effect of inhalation injury on burn-induced resting energy expenditure (REE) measurements in children with severe burns. REE, as measured by indirect calorimetry, was used to determine the metabolism levels of patients and to guide their nutrition. Eighty-six children (1–18 years) with 40 percent or more of their total body surface area burned were divided into two groups based on their diagnosis: no inhalation injury and inhalation injury. Inhalation injury was diagnosed based on bronchoscopic evaluation. For both groups REE, percent predicted REE, and oxygen consumption were measured at admission, at burn day 10, and when patients were 95 percent healed. At admission, PaO2:FiO2 ratios (an index of respiratory distress) were significantly higher in patients with no inhalation injury than in patient with inhalation injury. No differences were detected in REE or percent of the predicted basal metabolic rate between groups. Additionally, oxygen consumption did not significantly differ between groups. Findings suggest that inhalation injury does not augment the burn-induced hypermetabolic stress response in children, as reflected by REE and oxygen consumption.

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