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Nutrition in Pediatric Burns.

Amy A Mrazek^1,2, Preston Simpson³, Jong O Lee^1,2

¹Department of Burn Surgery, Shriners Children's Texas, Galveston, Texas.

Seminars in Plastic Surgery

|May 15, 2024

Summary

Optimizing nutrition is key for pediatric burn patients. This review covers caloric needs, essential nutrients, and pharmacologic interventions to manage the hypermetabolic response and support recovery.

Keywords:

enteral and parenteral nutrition growth hormone indirect calorimetry insulin insulin-like growth factor binding protein-3 malnutrition oxandrolone propranolol

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Area of Science:

Burn Care
Nutritional Science
Metabolic Response

Background:

Acute burns trigger a hypermetabolic response, increasing nutritional demands.
Malnutrition is a significant risk in pediatric burn patients, complicating recovery.
Effective nutritional management is crucial for rehabilitation outcomes.

Purpose of the Study:

To review nutritional strategies for modulating the hypermetabolic response in acute burns.
To evaluate methods for determining caloric requirements in burn patients.
To discuss the role of specific nutrients and pharmacologic agents in burn care.

Main Methods:

Evaluation of indirect calorimetry and predictive equations for caloric needs.
Discussion of individual nutritional components (carbohydrates, fat, protein, vitamins, trace elements).
Review of pharmacologic agents (growth hormone, insulin, propranolol, oxandrolone) for catabolic state management.

Main Results:

Enteral high-carbohydrate, low-fat diets are preferred.
Early recognition of malnutrition is critical for managing variable needs.
Pharmacologic interventions aid in addressing the catabolic state.

Conclusions:

A multipronged nutritional approach is essential for pediatric burn patients.
Optimized nutrition provides substrates for successful recovery and rehabilitation.
Integrated care combining nutritional support and pharmacotherapy improves outcomes.