Related Experiment Video
Updated: Aug 20, 2026
Using Deuterium Oxide as a Non-Invasive, Non-Lethal Tool for Assessing Body Composition and Water Consumption in Mammals
Published on: February 20, 2020
Body water in children during recovery from severe burn injury using a combined tracer dilution method
Kathy Prelack1, Joanna Dwyer, Robert Sheridan
1Shriners Hospitals for Children, Shriners Burns Hospital-Boston, 51 Blossom Street, Boston, MA 02114, USA.
Insights
Monitoring intracellular water (ICW) and extracellular water/intracellular water (ECW/ICW) ratio aids in assessing hydration and body cell mass (BCM) in severely burned children during recovery.
Area of Science:
- Biomedical Engineering
- Clinical Nutrition
- Pediatric Critical Care
Background:
- Accurate assessment of hydration and body cell mass (BCM) is crucial for managing severely burned children.
- Total body water (TBW) and its components, extracellular water (ECW) and intracellular water (ICW), provide key insights.
- Changes in ICW serve as a proxy for BCM, while the ECW/ICW ratio indicates water distribution.
Purpose of the Study:
- To evaluate the utility of monitoring ICW and the ECW/ICW ratio in severely burned children during recovery.
- To assess changes in body water compartments and their implications for hydration and nutritional status.
Main Methods:
- A combined tracer dilution method using deuterium for TBW and bromide for ECW was employed.
- Measurements were taken to determine ICW and the ECW/ICW ratio over the recovery period.
- Nine severely burned children were included in the study.
Main Results:
- During acute recovery, children experienced significant ICW losses (18.5%).
- The ECW/ICW ratio increased in the acute phase, indicating ECW expansion relative to ICW.
- During rehabilitation, ICW increased (31.9%), and the ECW/ICW ratio normalized, reflecting ICW recovery and ECW reduction.
Conclusions:
- Tracking ICW and the ECW/ICW ratio is a practical method for monitoring BCM and water distribution in burned children.
- These indices offer valuable information on hydration and nutritional status during recovery from severe burns.
Abstract:
Useful information about hydration and the size of the body cell mass (BCM) can be obtained by monitoring changes in the amount of total body water (TBW) and its components, extracellular water (ECW) and intracellular water (ICW). A combined tracer dilution method with deuterium to measure TBW and bromide to measure ECW was used to assess changes in ICW (as a proxy for the BCM) and in the ECW/ICW ratio (an indicator of water distribution) over the course of recovery in nine severely burned children. During the acute phase of recovery, ICW losses averaged (mean +/- SD) 2.2 +/- 2.0 liters (P = .02) or 18.5 +/- 0.4%. During the rehabilitative phase, mean ICW increased by 3.4 +/- 3.7 liters or 31.9 +/- 14%. The ECW/ICW ratio varied widely both between patients and during the course of the study. During the acute phase of recovery, the mean ECW/ICW ratio increased from 1.06 +/- 0.15 liters to 1.20 +/- 0.14 liters because the ECW compartment had expanded relative to the ICW compartment. During rehabilitation, the ECW/ICW ratio decreased from 1.20 +/- 0.14 liters to 0.86 +/- 0.20 liters, with a recoup of ICW and continued ECW losses. Tracking ICW and the ECW/ICW ratio using the combined tracer dilution method is practical for monitoring BCM and water distribution in severely burned children. Taken together, the indices provide useful information about hydration and nutritional status in individuals recovering from severe burn injury.
