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Growth delay in postburn pediatric patients
1Shriners Burns Institute, Galveston, TX 77550.
Insights
Severe burns in children significantly slow growth, impacting height and weight velocity. This growth delay, observed in the first year post-burn, gradually improves over three years despite nutritional support.
Area of Science:
- Pediatric medicine
- Burn surgery
- Endocrinology
Background:
- Postburn pediatric populations exhibit reduced height and weight velocities.
- Severe thermal injury may impact long-term growth in children.
Purpose of the Study:
- To validate the phenomenon of dampened growth velocities in pediatric burn survivors.
- To assess growth patterns in children following severe burn injuries.
Main Methods:
- Retrospective review of 80 pediatric patients with >40% total body surface area burns.
- Analysis of yearly growth velocities up to 3 years post-burn in patients treated with early excision and standard support.
Main Results:
- Admission height and weight were within normal parameters.
- A significant growth arrest was observed in postburn year 1.
- Growth velocities approached normal distribution by postburn year 3.
Conclusions:
- Severe thermal injury is associated with a distinct growth delay in pediatric patients.
- The precise mechanisms underlying this postburn growth phenomenon require further investigation.
Abstract:
Dampened height and weight velocities have been observed in our postburn pediatric population. To validate this phenomenon, the medical records of 80 patients who had sustained a greater than 40% total body surface area burn, were older than 2 years of age at the time of the burn, and were at least 1 year post burn were reviewed. All patients were treated with early excision of the burn wound within 72 hours of injury and received standard post burn resuscitational and nutritional support. Admission height and weight plots were within normal distribution parameters. Yearly growth velocities were calculated for up to 3 years after the burn. Despite adequate nutritional support and maximal exercise and/or long-bone stresses, a profound growth arrest was noted during postburn year 1, which slowly resolved to near normal distribution by postburn year 3. This retrospective study demonstrates that severe thermal injury is associated with a growth delay in the pediatric population. The exact cause of this phenomenon remains unknown.