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Fever in burned children
1Regional Paediatric Burns Unit, Booth Hall Children's Hospital, Manchester, UK.
Insights
Pediatric burn patients often develop fever within 48 hours, with rectal temperature (Tr) rising rapidly in the first 12 hours. Age is a key factor influencing temperature changes after burn injury.
Area of Science:
- Pediatric Burn Care
- Thermoregulation in Children
- Critical Care Medicine
Background:
- Burn injuries in children can significantly disrupt normal thermoregulation.
- Post-burn fever is a common complication requiring careful monitoring.
Purpose of the Study:
- To investigate rectal temperature (Tr) and skin temperature patterns in pediatric burn patients.
- To identify factors influencing temperature changes in the first 48 hours post-burn.
Main Methods:
- Studied rectal temperature (Tr), thigh (Tthigh), and toe (Ttoe) temperatures in 40 children post-burn.
- Monitored temperatures for 48 hours following burn injury and intravenous resuscitation.
Main Results:
- Rectal temperature (Tr) was elevated in 19 children on admission (2-6h post-burn).
- Fever (Tr > 38.5°C) occurred in 67% of patients within 12 hours; 10 children exceeded 40.0°C.
- Age was the most significant variable, with a positive correlation between Tr and age in infants (5-23 months).
- Thigh temperature (Tthigh) mirrored Tr, while Ttoe reflected cardiovascular and thermoregulatory responses.
Conclusions:
- Pediatric burn patients frequently experience elevated rectal temperatures and fever within 48 hours.
- Age is a critical factor in thermoregulation post-burn, particularly in infants.
- Skin temperature variations provide insights into both thermoregulation and cardiovascular status.
Abstract:
The patterns of rectal temperature (Tr) and skin surface temperatures (Tthigh and Ttoe) of 40 children were studied during the first 48 h after burn injury. The patients' ages ranged from 5 months to 12 years and all required intravenous resuscitation. On admission Tr measured 2-6h after the burn, ranged from 36.5 to 39.0 degrees C and 19 children had temperatures greater than 37.5 degrees C; the upper limit of the normal range for healthy children. Patients 5-12 months old had the lowest Tr during the early period. During the first 12 h Tr rose rapidly and 27 patients (67 per cent) had a fever (Tr greater than 38.5 degrees C). In 10 children Tr was greater than 40.0 degrees C. There was no relationship between the rise in Tr and the sex of the patient, the ambient temperature, the size, site or type of burn. Age was the most important variable, particularly during the first 12 h, where a positive correlation between Tr and age occurred in patients aged 5-23 months (P less than 0.01, r = 0.53). Throughout the first 48 h Tr remained elevated. Tthigh closely followed the pattern of Tr, but Ttoe varied considerably, reflecting cardiovascular as well as thermoregulatory responses.