Related Experiment Videos
Energy balance studies and plasma catecholamine values for patients with healed burns
B H Wallace1, J B Cone, F T Caldwell
1Arkansas Children's Hospital Burn Center, Little Rock.
Insights
Children and young adults with healed burn wounds maintain normal heat production. However, increased evaporative heat loss leads to surface cooling and reduced dry heat loss post-burn.
Area of Science:
- Physiology
- Burn Medicine
- Thermoregulation
Background:
- Burn injuries significantly impact thermoregulation.
- Assessing heat balance in patients with healed burn wounds is crucial for recovery.
Purpose of the Study:
- To investigate heat balance and plasma catecholamine levels in pediatric and young adult patients with healed burn wounds.
- To determine if healed burn wounds affect resting heat production and heat loss mechanisms.
Main Methods:
- Conducted heat balance studies on 49 children and young adults with healed burns.
- Measured plasma catecholamine levels (epinephrine, norepinephrine, dopamine) at discharge.
- Compared patient data to predicted normal values and control subjects.
Main Results:
- Resting heat production was not significantly different from normal predicted values.
- Evaporative heat loss was persistently elevated due to increased cutaneous water vapor loss.
- Dry heat loss was decreased, resulting in a lower average surface temperature compared to controls.
Conclusions:
- Patients with freshly healed burn wounds exhibit normal heat production.
- Residual increase in transcutaneous water vapor loss causes surface cooling and reduced dry heat loss.
- These findings highlight ongoing thermoregulatory adjustments after burn healing.
Abstract:
We report heat balance studies and plasma catecholamine values for 49 children and young adults with healed burn wounds (age range 0.6 to 31 years and burn range 1% to 82% body surface area burned; mean 41%). All measurements were made during the week of discharge. Heat production for patients with healed burns was not significantly different from predicted normal values. However, compartmented heat loss demonstrated a persistent increment in evaporative heat loss that was secondary to continued elevation of cutaneous water vapor loss immediately after wound closure. A reciprocal decrement in dry heat loss was demonstrated (as a result of a cooler average surface temperature, 0.84 degree C cooler than the average integrated skin temperature of five normal volunteers who were studied in our unit under similar environmental conditions). Mean values for plasma catecholamines were in the normal range: epinephrine = 56 +/- 37 pg/ml, norepinephrine = 385 +/- 220 pg/ml, and dopamine = 34 +/- 29 pg/ml. In conclusion, patients with freshly healed burn wounds have normal rates of heat production; however, there is a residual increment in transcutaneous water vapor loss, which produces surface cooling and decreased average surface temperature, which in turn lowers dry heat loss by an approximately equivalent amount.