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Influence of fever on the hypermetabolic response in burn-injured children

Dennis C Gore1, David Chinkes, Arthur Sanford

  • 1Department of Surgery-Trauma, The University of Texas Medical Branch, 301 University Blvd, Route 1172, Galveston, TX 77555, USA.

Archives of Surgery (Chicago, Ill. : 1960)
|February 13, 2003
PubMed

Insights

Severe fever significantly worsens energy expenditure and muscle protein breakdown in hypermetabolic children with severe burns. Reducing fever may offer metabolic benefits for these patients.

Area of Science:

  • Metabolic research
  • Pediatric critical care
  • Burn injury research

Background:

  • Burn injuries induce a hypermetabolic state, increasing energy needs and muscle protein breakdown.
  • Fever exacerbates this hypermetabolism, leading to greater energy expenditure and muscle loss in burn patients.

Purpose of the Study:

  • To investigate the impact of fever on energy expenditure and muscle protein catabolism in children with severe burns.

Main Methods:

  • Retrospective analysis of an experimental study conducted at a university hospital.
  • Included 84 children (aged 2-18 years) with burns affecting 40% or more of their total body surface area.
  • Measured indirect calorimetry and leg phenylalanine net balance, stratifying patients by rectal temperature (afebrile, mild, moderate, severe fever).

Main Results:

  • Severe fever (>=40.0°C) was linked to significantly higher resting energy expenditure compared to afebrile patients.
  • Patients with severe fever exhibited a greater net loss of phenylalanine from the leg, indicating increased muscle protein catabolism.
  • No significant differences were observed in plasma glucose or leukocytosis between fever groups.

Conclusions:

  • Severe fever is associated with increased energy expenditure and muscle protein catabolism in hypermetabolic burned children.
  • Attenuating fever in these patients may provide metabolic advantages.
  • Highlights the critical role of fever management in pediatric burn care.
Abstract

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