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Caloric requirements of patients with burns under one year of age
M A Hildreth1, D N Herndon, M H Desai
1Shriners Burns Institute, Galveston, TX 77550.
Insights
New research establishes caloric needs for infants with extensive burns. Body surface area is the primary factor in determining calorie requirements for these vulnerable pediatric patients.
Area of Science:
- Pediatric critical care
- Burn management
- Nutritional support
Background:
- Existing pediatric caloric formulas do not specifically address the unique needs of infants with severe burns.
- Accurate nutritional assessment is crucial for weight maintenance and recovery in burn patients.
Purpose of the Study:
- To determine the specific caloric intake required for weight maintenance in infants (under 1 year) with burns exceeding 25% of total body surface area.
- To compare actual caloric needs with existing pediatric formulas.
Main Methods:
- A study involving thirty infant patients with severe burns (over 25% TBSA).
- Analysis of actual caloric intake required for weight maintenance.
- Multivariate regression analysis to identify predictors of caloric requirements.
Main Results:
- Published pediatric caloric formulas were found to be inadequate for this patient group.
- Both body surface area (BSA) and burn surface area (BSA burned) were significant predictors of caloric needs.
- BSA was identified as the more critical predictor in the infant population.
Conclusions:
- A new, specific formula is necessary for estimating caloric requirements in infants with severe burns.
- The proposed formula is 2100 kcal/m² BSA/day + 1000 kcal/m² BSA burned/day.
- This finding emphasizes the importance of BSA as a primary determinant of nutritional needs in pediatric burn care.
Abstract:
Formulas for estimating the caloric requirements of pediatric patients with burns have been suggested. However, the needs of infant patients with burns have not been specifically addressed. This study was undertaken to determine the caloric intake required to maintain weight in patients under 1 year of age who had burns covering more than 25% total body surface area. Thirty patients were studied, and a comparison was made between the actual intake required for weight maintenance and the suggested calorie levels provided by published pediatric caloric formulas. The results indicated that a new formula was needed. Multivariate regression analysis indicated that body surface area and burn surface area were significant predictors of caloric requirements, but body surface area was the more important predictor in this infant population. The equation resulting from the regression provides 2100 kcal/m2 body surface area/day plus 1000 kcal/m2 body surface area burned/day.