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Body Composition Changes with Time in Pediatric Burn Patients

Przkora, Rene MD, PhD; Barrow, Robert E. PhD; Jeschke, Marc G. MD, PhD; Suman, Oscar E. PhD; Celis, Mario PA; Sanford, Arthur P. MD; Chinkes, David L. PhD; Mlcak, Ronald P. PhD; Herndon, David N. MD

Journal of Trauma-Injury Infection & Critical Care:
doi: 10.1097/01.ta.0000214580.27501.19
Original Articles
Abstract

Background: Major trauma and burns are associated with whole body catabolism which can persist for 1 or more years after injury. This study investigates body composition in massively burned children for up to 2 years.

Methods: Twenty-five pediatric patients with greater than 40% total body surface area burns were studied. At discharge, 6, 12, 18, and 24 months after burn height, weight, body composition, resting energy expenditure (REE), serum growth hormone, insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), insulin, cortisol, parathyroid hormone, and thyroid hormones were measured. Tukey’s test was used for analysis. Significance was accepted at p < 0.05.

Results: Lean body mass, fat mass, bone mineral content, height, and weight increased significantly during the second year after burn. Percent predicted REE decreased significantly, whereas IGFBP-3 and parathyroid hormone levels increased significantly over time. Insulin and T3 uptake were significantly higher at discharge.

Conclusions: Body composition of severely burned children significantly improved in the second year compared with the first year after injury. This demonstrates a need for long-term rehabilitation in these burn patients.

Author Information

From the Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, Galveston Texas.

Submitted for publication November 22, 2005.

Accepted for publication February 6, 2006.

Supported by the National Institutes of Health Grants P01-GM60338-01, T32-GM08256-07, K01-HL070451; National Institute for Disability and Rehabilitation Research Grant H133A70019; and Shriners Hospital Grants 8952 and 8760.

Presented at the 64th Annual Meeting of the American Association for the Surgery of Trauma, September 22–24, 2005, Atlanta, Georgia.

Address for reprints: David N. Herndon, MD, FACS, Shriners Hospitals for Children, 815 Market St., Galveston, TX 77550; email: dherndon@utmb.edu.

© 2006 Lippincott Williams & Wilkins, Inc.