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A prospective analysis of serum vitamin K in severely burned pediatric patients
M E Jenkins1, M M Gottschlich, R Kopcha
1Shriners Burns Institute, Cincinnati, OH 45229, USA.
Insights
Children with burns often develop vitamin K deficiency due to various factors. This study found low vitamin K levels in 91% of pediatric burn patients, linked to therapies and burn severity.
Area of Science:
- Biochemistry
- Pediatric Medicine
- Nutritional Science
Background:
- Burn injuries present numerous risk factors for vitamin K deficiency.
- These include malabsorption, poor nutrition, antibiotic use, and surgeries.
- Vitamin K is crucial for blood clotting.
Purpose of the Study:
- To evaluate serum vitamin K levels in pediatric burn patients.
- To correlate vitamin K status with clinical factors during the initial postburn period.
- To understand the relationship between coagulopathy and gastrointestinal function in burn patients.
Main Methods:
- Prospective evaluation of 48 children with burn injuries.
- Measurement of serum vitamin K values during the first four weeks postburn.
- Analysis of serum levels in relation to clinical course and treatments.
Main Results:
- Ninety-one percent of children had serum vitamin K levels below expected norms.
- Antibiotic therapy, albumin therapy, body surface area excised, and blood product administration correlated with lower vitamin K.
- Days of diarrhea approached statistical significance for correlation with low vitamin K.
- No correlation found between serum vitamin K and prothrombin time, activated partial thromboplastin time, or serum albumin.
Conclusions:
- Pediatric burn patients frequently exhibit vitamin K deficiency.
- Clinical factors like antibiotic use and burn severity are associated with reduced vitamin K levels.
- Further research is needed to differentiate the roles of dietary and bacterial vitamin K in burn patients.
Abstract:
Patients with burn injuries exhibit multiple risk factors for the development of vitamin K deficiency, including malabsorption, limited enteral intake, antibiotic therapy, and multiple surgical procedures. A prospective evaluation of 48 children was conducted to evaluate serum vitamin K values during the first 4 postburn weeks. Serum levels were analyzed in relation to clinical course. Days of antibiotic (p < 0.02) and albumin therapy (p < 0.003), percentage body surface area excised (p < 0.006), and the administration of blood products (p < 0.05) were significantly correlated with serum vitamin K levels, and days of diarrhea approached statistical significance (p < 0.06). No relationship was found between serum values and prothrombin time, activated partial thromboplastin time, or serum albumin. Ninety-one percent of the children demonstrated serum values below expected norms. These data suggest a relationship between coagulopathy and an intact functioning gastrointestinal tract. However, the relative importance of dietary versus endogenous vitamin K produced by intestinal bacteria remains to be elucidated.