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

Cunningham JJ, Lydon MK, Russell WE
Am J Clin Nutr. 1990 51 (4): 553-7

PMID: 2108578 · DOI:10.1093/ajcn/51.4.553

Severely burned adults increase their metabolic energy expenditure (MEE) to levels approaching twice the normal resting metabolic rate (RMR). There are no available measurements of MEE for severely burned infants and toddlers, however, and nutritional support relies on published estimates of MEE that range from 200% to 400% of RMR. We determined the actual calories provided to 10 infants and children ages 3-33 mo during acute care for severe burns (59 +/- 5% total-body-surface burn). Our standard protocol emphasizes the delivery of amino acids at 3 g.kg-1.d-1 in conjunction with prompt excision and grafting. An anabolic state characterized by weight maintenance and healing was supported with far fewer calories than predicted by four published formulas for MEE. We conclude that when greater than 2.5 g.kg-1.d-1 protein is provided, efficient protein utilization for recovery is achieved with calorie provision at 120-200% RMR in severely burned infants and toddlers.

MeSH Terms (15)

Burns Burn Units Child, Preschool Dietary Proteins Energy Intake Energy Metabolism Female Humans Infant Infant Nutritional Physiological Phenomena Intensive Care Units, Pediatric Male Nitrogen Parenteral Nutrition, Total Prognosis

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