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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #161691
Title: Growth Deceleration and Restoration After Serious Burn Injury

Author
item PRELACK, KATHY - TUFTS-HNRCA
item DWYER, JOHANNA - TUFTS-HNRCA
item Dallal, Gerald
item RAND, WILLIAM - TUFTS SCHOOL OF MED
item YU, Y - SHRINERS HOSP FOR CHLDRN
item Kehayias, Joseph
item ANTOON, ALIA - SHRINERS HOSP
item SHERIDAN, R - FRANCES STERN NUTR CTR

Submitted to: Journal of Burn Care and Rehabilitation
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/14/2006
Publication Date: 4/1/2007
Citation: Prelack, K., Dwyer, J., Dallal, G., Rand, W.M., Yu, Y.M., Kehayias, J.J., Antoon, A., Sheridan, R. 2007. Growth Deceleration and Restoration After Serious Burn Injury. Journal of Burn Care and Rehabilitation. 28(2):262-268.

Interpretive Summary: Useful information about hydration and body composition can be obtained by monitoring changes in the amount of total body water and its components, extracellular water and intracellular water. Deuterium, a stable isotope was used to measure total body water and sodium bromide, a salt, was used to measure extracellular water over the course of recovery in 9 severely burned children. Intracellular water, an indicator of the body cell mass, which is the metabolically active compartment of the lean body mass, was estimated by subtracting extracellular from total body water. During the acute phase of recovery, intracellular water decreased by 19%. During the rehabilitative phase, intracellular water increased by 32%. Taken together, the indices demonstrated that the metabolically active component of lean body mass is significantly altered following burn injury. In addition, an inpatient rehabilitative treatment plan, with nutritional therapy helps to recoup losses of the body cell mass compartment in previously burned children. This methodology has wide application in individuals with altered hydration and changes in nutritional status.

Technical Abstract: Useful information about hydration and the size of the body cell mass (BCM) can be obtained by monitoring changes in the amount of total boy water (TBW) and its components, extracellular water (ECW) and intracellular water (ICW). A combined tracer dilution method with deuterium to measure TBW and bromide to measure ECW was used to assess changes in ICW (as a proxy for the BCM), and in the ECW/ICW ratio (an indicator of water distribution) over the course of recovery in 9 severely burned children. During the acute phase of recovery, ICW losses averaged (mean +/- SE) 2.4 +/- 0.9L (P=0.05) or 18.5 +/- 0.4%. During the rehabilitative phase, means ICW increased by 3.7 +/- 1.2L (P=0.03) or 31.9 +/- 14%. The ECW/ICW ratio varied widely both between patients and over the course of study. During the acute phase of recovery, the mean ECW/ICW ration increased from 1.06 +/- 0.15 to 1.20 +/- 0.14, because the ECW compartment had expanded relative to the ICW compartment. During rehabilitation, the ECW/ICW ration decreased from 1.20 +/- 0.14 to 0.86 +/- 0.20, with a recoup of ICW and continued ECW losses. Tracking ICW and the ECW/ICW ration using the combined tracer dilution method is practical for monitoring BCM and water distribution in severely burned children. Taken together, the indices provide useful information about the hydration and nutritional status in individuals recovering from severe burn injury.