Some of the metabolic derangements in 1-15 year old burned children

ABSTRACT

Burn is the main cause of mortalities in children after motor accidents. One of the most important responses of the body to burn is creating changes in metabolic system and food needs. These changes are generally formed in intensive and high degree burns. So, in spite of the existence of just one source ward [Imam Reza burn ward], we decided to accomplish a comprehensive research study on the population of the children who were admitted in this center, consuming the existing facilities. In this descriptive-cross sectional research, 452 burned children aging 1 to 15 years old [268 boys and 184 girls] were surveyed. All the patients were being treated at the burn ward in Imam Reza Hospital for over one year [i.e. from 20/04/2004 to 24/06/2005]. Three metabolic criteria including Fasting Blood Sugar, Total Serum Protein and Serum Lipid Profiles and [cholesterol and triglycerides] were measured in 3 phases a] the first day of confining, b] in the first week, c] at the dismissing time. All the patients were revived according to Brooke formula, and some changes were made in the base of clinical situation, patient's responses, and the age groups. NG tube was inserted and food supply was provided for all the patients with more than 15% burn. In this research, 184 girls [40.7%] and 268 boys [59.3%] aging from 1 to 15 years were examined. Regarding the factor of sex between the two groups, the mean age in the boys was 5.89 +/- 1.3 years, while in girls, it was 2.28 +/- 2.1 year. As for the etiology of burn, the degree of prevalence rated as 74.8% with hot liquids; 23.9% with flame; 0.6% with electricity. In terms of the mean percentage of burning, it was 23.2% in the girls and 26.7% in the boys. The mean and standard deviation of the duration of hospitalization was respectively 14.12 and 11.51 days for the girls and 17.97and 14.83 days for the boys. Over the period of hospitalization, 67 patients including 32 girls [17.39%] and 35 boys [13.05%] died because of the intensive burn or its side effects [14.82%]. Regarding the metabolic criteria changes, the most changes occurred in the following order 1] the changes in blood sugar articularly between the first day and the first week of hospitalization], 2. The rate of serum fats 3 .The rate of serum protein [especially, between the first day and the first week of hospitalization]. Heat injuries resulted from burns can cause dramatic changes in the patients' metabolic system and nutrition, particularly for children. Having a good control over these changes, a well-timed treatment and utilizing suitable reviving methods can have vital roles in decreasing the mortalities as well as the duration of hospitalization