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Updated: Sep 26, 2026
Severe Burn Injury in a Swine Model for Clinical Dressing Assessment
Published on: November 6, 2018
Sodium bromide by instrumental neutron activation analysis quantifies change in extracellular water space with wound
Kathy Prelack1, Robert Sheridan, Yong-Ming Yu
1Nutrition Support, Shriners Hospitals for Children, 51 Blossom Street, Boston, MA 02114, USA.
Insights
Extracellular water (ECW) significantly decreases in burned children as wounds close, alongside weight loss. Bromide dilution space offers a practical bedside method for monitoring ECW changes during recovery.
Area of Science:
- Pediatric critical care
- Fluid homeostasis and body composition analysis
Background:
- Measuring extracellular water (ECW) is vital for critically ill patients.
- ECW assessment aids in fluid homeostasis, body composition, and nutritional therapy response.
- This study investigated ECW changes in acutely burned children.
Purpose of the Study:
- To determine changes in extracellular water (ECW) during wound closure in severely burned children.
- To evaluate the utility of corrected bromide space for ECW measurement.
Main Methods:
- Fifteen children with >30% total body surface area burns were studied post-stabilization.
- Extracellular water (ECW) was measured using corrected bromide space (CBS).
- Plasma bromide levels were quantified via instrumental neutron activation analysis.
Main Results:
- Mean CBS decreased significantly (P=.04) with wound closure, indicating reduced ECW.
- A significant decline in body weight was also observed (P=.007).
- The proportion of ECW to weight did not change significantly.
Conclusions:
- A significant reduction in ECW occurs with wound closure in burned children.
- Weight loss accompanies the decrease in ECW during recovery.
- Bromide dilution space is a convenient bedside method for monitoring ECW.
Background:
The ability to measure extracellular water (ECW) in critically ill patients can significantly enhance current methods of assessing fluid homeostasis, body composition, and response to nutritional therapy. We measured corrected bromide space to determine change in ECW with wound closure among acutely burned children.
Methods:
Fifteen children with burns over 30% of their total body surface area had their ECW determined following hemodynamic stabilization and when wound closure was complete. Plasma samples were obtained at baseline and 4 hours after receiving 25 mg/kg of sodium bromide. Plasma bromide was quantified by instrumental neutron activation analysis.
Results:
Mean CBS decreased with wound closure (9.1 +/- 4.1 vs 7.9 +/- 3.9 liters; P =.04), indicating a significant decrease in ECW over the course of recovery. A decline in weight also occurred over the same period (32.4 +/- 15.2 vs 29.1 +/- 13.5 kg; P =.007); however, change in corrected bromide space as a proportion of weight was not statistically significant.
Conclusion:
A significant decrease in ECW accompanies the weight loss observed in patients following wound closure. Measurement of bromide dilution space is a convenient method for monitoring ECW that can be done at the bedside.
