Journal Article

407 Growth Velocity in Pediatric Burn Patients 0–5 Years Old

S Maas, D Neal, D Greenhalgh, S Sen and T Palmieri

in Journal of Burn Care & Research

Volume 39, issue suppl_1, pages S175-S175
Published in print April 2018 | ISSN: 1559-047X
Published online April 2018 | e-ISSN: 1559-0488 | DOI: https://dx.doi.org/10.1093/jbcr/iry006.329
407 Growth Velocity in Pediatric Burn Patients 0–5 Years Old

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  • Medicine and Health
  • Acute Medicine
  • Emergency Medicine
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  • Surgery

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Abstract

Introduction

In children with burn injuries, nutritional needs are significantly increased to promote healing and help keep them on their predicted growth curve. This is especially apparent in the 0–5 year pediatric population, as this is period of rapid growth. To help our patients meet the increased nutrient needs, we insert post-pyloric feeding tubes in our patients with >20% TBSA and begin enteral feedings on admission. Most patients with <20% TBSA will consume a regular oral diet. The goal of this study is to determine if our 0–5 year pediatric patients with >10% TBSA stay on their projected growth curve upon discharge.

Methods

After obtaining regulatory approval from our local institutional review board, we performed a retrospective review of pediatric burn injured patients admitted to our center from January of 2010 to August of 2017. The inclusion criteria for the study included the following: 0–5 year old with greater than 10% TBSA burns who were hospitalized for more than 10 days. The following data was collected and analyzed: demographics, nature and extent of burn injury, length of hospital stay, admission weight with growth scale percentile and discharge weight with growth scale percentile.

Results

A total of 170 pediatric patients met the criteria for our study. Of these patients the median age was 2.6(sd=1.6) years, 99 patients were male and 71 were female. The average TBSA percentage was 25% (sd=13.5%), median length of stay 27 days (range of 17–42). Of the 170 patients 90 received tube feedings. The average admission weight was 14.5kg (sd=4.8), average discharge weight 13.9 (sd=4.4) there was a median weight loss of only 0.5kg. Using the World Health Organization’s pediatric growth scale our patients averaged on the 70th percentile on admission with a median decrease of 8.15 percentiles upon discharge. All patients with 40% TBSA or greater received tube feeds. Tube fed patients overall gained more weight, however they did not have a significantly different change in growth scale percentile. There was no difference in weight gain or growth scale change in patients with a TBSA of 10–19% between tube fed and non-tube fed patients. There was a significant increase in both weight and growth scale in patients who were tube fed with a TBSA of 20–39% compared to non-tube fed patients.

Conclusions

In patients with moderate to severe burn wounds, tube feedings may improve or maintain both weight and growth velocities. Further study is needed on the long term effects of moderate to severe burns on growth velocity.

Applicability of Research to Practice

Pediatric burn patients have increased nutritional needs to promote healing and to maintain their natural growth velocity. This study further indicates the need to provide optimal nutrition via enteral nutrition for large burns in order to promote healing and maintain a normal growth curve.

Journal Article.  0 words. 

Subjects: Medicine and Health ; Acute Medicine ; Emergency Medicine ; Critical Care ; Surgery

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