A longitudinal study of resting energy expenditure in thermally injured patients

We have recently developed a new burn-specific equation that satisfactorily estimates initial caloric requirements for thermally injured patients. In the present study, we compared these estimates with resting energy expenditures (REE) (n = 141) measured weekly by indirect calorimetry in 20 patients between postburn days 3 and 348. In this group, mean initial burn size was 46.7% (range, 21-88) and mean age 31.3 years (range, 19-61). Serial measurements were continued until the burn wounds were closed or the patient was discharged. Multiple regression analysis indicated a relationship between REE, initial burn size, and postburn day in these patients (r = 0.65). This analysis indicated a general trend of decline in REE toward normal values 100 to 150 days postburn in patients with smaller burns (20%-40%) and roughly 250 days postinjury in those with larger burns (> 75%). The initial predictive equation appeared adequate for estimating caloric needs during the first postburn month, but beyond 30 days postburn indirect calorimetric measurements became necessary for accurate estimation of caloric requirements.