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Early Manipulation of Metabolic Changes due to Severe Burns in Children

  • Conference paper
Intensive Care Medicine

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 2007))

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Abstract

Burns account for around 700,000 emergency department visits every year resulting in around 50,000 admissions to hospital in the United States [1]. Around 50% of these admissions have burns of less than 10% total body surface area (TBSA) and, as such, have near normal metabolic rates. For the remainder, the rise in metabolic rate is linked to burn size and for those with severe thermal injuries (>40% TBSA) the change in patient metabolism is, if left unchecked, set to last for more than 12 months. The change contributes, at least in part, to long term deleterious effects on the individual. It has been previously shown that the ensuing period of hypermetabolism and catabolism following a severe burn leads to impaired immune function, decreased wound healing, erosion of lean body mass, and hinders rehabilitative efforts delaying reintegration into normal society. However, the magnitude and longevity of these changes has yet to be fully elucidated. Strategies for attenuating these maladaptive responses may be divided into pharmacological and non-pharmacological. Non-pharmacological approaches include prompt, early excision and closure of wounds, pertinacious surveillance for and treatment of sepsis, early commencement of high protein high carbohydrate enteral feeding, elevation of the immediate environmental temperature to 31.5°C (±0.7°C), and early institution of an aerobic resistive exercise program.

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Author information

Authors and Affiliations

  1. Department of Surgery, Shriners Hospitals for Children, 815 Market Street, Galveston, TX, 77550, USA

    W. B. Norbury & D. N. Herndon

  2. Department of Surgery, Shriners Hospital for Children, Galveston Burns Unit, 815 Market Street, Galveston, TX, 77550

    M. G. Jeschke

Authors
  1. W. B. Norbury
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  2. M. G. Jeschke
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  3. D. N. Herndon
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© 2007 Springer Science + Business Media Inc.

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Norbury, W.B., Jeschke, M.G., Herndon, D.N. (2007). Early Manipulation of Metabolic Changes due to Severe Burns in Children. In: Intensive Care Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 2007. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49433-1_70

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  • DOI: https://doi.org/10.1007/978-3-540-49433-1_70

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-49432-4

  • Online ISBN: 978-3-540-49433-1

  • eBook Packages: MedicineMedicine (R0)

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