Calorie and protein provision for recovery from severe burns in infants and young children

Article Abstract:

Adults who suffer severe burns have greatly increased requirements for calories and protein. After burn injuries, the metabolic rate is dramatically increased and, therefore, extra nutrition is critical for proper healing and recovery. While research has been conducted for adults and older children with severe burns, there are no available data concerning the metabolic energy expenditure of infants and toddlers with severe burns. Ten children, aged 3 to 33 months, who suffered severe burns (full-thickness injury to more than 30 percent of the body) were studied. They were treated at Shriners Burns Institute in Boston with the standard protocol of that hospital, which included prompt excision of burned tissue with skin grafting and nutritional care consisting of both tube-feedings and parenteral (intravenous) nutrition. These treatments supported healing and prevented weight loss in the children. Records were kept of the children's nutritional intake. The amount of calories and protein they received was examined in order to estimate the amounts needed to support recovery, and establish a protocol for treating other young burn victims. The results from these 10 children showed that they needed far fewer calories than had been expected based on equations for calculating metabolic energy expenditure. It was concluded that infants and toddlers with severe burns need at least 2.5 grams of protein per kilogram of body weight per day and calories at the level of 120 to 200 percent of the resting metabolic rate (the calories burned for essential body processes while at rest). (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Injuries, Children, Pediatric injuries, Pediatric emergencies, Infants

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Very early nutrition supplementation in burned patients

Article Abstract:

Hypermetabolism, an increase in the metabolic rate, occurs following burns, and the increase in the rate of metabolism is proportional to the severity of the burn. The prognosis of burned patients is influenced their nutrition, since large amounts of calories, protein and other nutrients are needed for healing the burns. Previous studies have indicated that nutrition support benefits burn patients. In this study, two groups of 10 burn patients each were compared. One group received nutrition support beginning immediately after hospitalization, which was an average of four hours after the burn injury, while the other group began getting nutrition support an average of 58 hours after injury. The nutrition support was in the form of a tube feeding containing blenderized foods, given through a tube entering the nose and extending into the stomach. Patients who were supplemented early were hospitalized for 20 fewer days than patients supplemented later (69 versus 89 days). Many indicators of hormonal function and metabolism normalized more quickly in patients whose nutrition support started earlier. These markers included body weight, nitrogen balance (protein intake minus protein losses), levels of glucagon (a hormone which controls sugar production from proteins), catecholamines (hormones that contribute to hypermetabolism), and insulin, while cortisol (a hormone linked to stress) was not different between the two groups. The results indicate that nutrition support in the critical 24 hours following a burn can significantly influence patient recovery. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Shoulder girdle lipomatosis

Article Abstract:

Shoulder girdle lipomatosis is a disorder characterized by excessive accumulation of fat in the muscles connecting the upper arm to the body. The main symptoms of shoulder girdle lipomatosis are an increase in arm girth, weakness of shoulder and arm muscles, loss of sensation in the involved muscles, movement impairment and respiratory impairment. An increase in the mass of the fatty tissue over time causes displacement of muscle tissue. The neuropathy, or involvement of the nervous system, seen in patients with shoulder girdle lipomatosis is caused by infiltration of fatty tissue into the nerves. No effective treatment exists for shoulder girdle lipomatosis. Some patients may undergo surgery to have fatty tissue removed from the shoulder girdle. This only provides temporary relief and does not provide a solution to the muscular or neurological impairment caused by the disorder.

Bone diseases

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