Influence of inhalation injury on energy expenditure in severely burned children

Objective: Determine the effect of inhalation injury on burn-induced hypermetabolism in children. Design: Prospective study comparing hypermetabolism (i.e., resting energy expenditure and oxygen consumption) in burned children with and without inhalation injury during acute hospitalization. Setting: Single pediatric burn center. Patients: Eighty-six children (1-18 years) with ≥40% total body surface area burns were stratified to two groups: no inhalation injury and inhalation injury. Interventions: None. Main measurements and results: Inhalation injury was diagnosed based on bronchoscopic evaluation. At admission, PaO₂:FiO₂ ratios (an index of respiratory distress) were significantly higher in patients with no inhalation injury than in patient with inhalation injury. No differences were detected in resting energy expenditure or percent of the predicted basal metabolic rate between groups. Additionally, oxygen consumption did not significantly differ between groups. Conclusions: Inhalation injury does not augment the burn-induced hypermetabolic stress response in children, as reflected by resting energy expenditure and oxygen consumption.