What Kind of Factors Is Influencing Resting Energy Expenditure on Major Burn Patients?

Kim, Hanyoung; Cho, Yongsuk; Kim, Dohern; Hur, Jun; Chun, Wook; Park, Jiyoung; Kim, Jong Hyun; Choi, Gi Hun; Lim, Hae Jun

Abstract

PURPOSE
Burn injury is among the most severe type of trauma that the body can sustain. The major burn increases energy expenditure as the result of its induction of the hypermetabolic and catabolic state. It is well-documented that nutritional support may improve morbidity and mortality after severe burn injury. Therefore, adequate nutritional support is essential in burned patients to prevent the detrimental consequences of overfeeding and underfeeding. The purpose of this study was to analyze the factors influencing resting energy expenditure on major burn patients.
METHODS
In 199 patients with > or =20% total body surface area (TBSA) burn were monitored with 403 measurement of resting energy expenditure (REE) from January 2004 to December 2008 in burn center of the Hangang Sacred Heart Hospital. Gender, age, burn size, inhalation injury, ventilator were included in the factors which influence the REE of massive burn patients.
RESULTS
The measured REE and REE/basal metabolic rate (BMR) were significantly higher in males (p<0.05). The measured REE and REE/body mass index (BMI) showed significant difference between age groups (p<0.01). The measured REE and REE/BMI showed significant difference between burn size groups (p<0.01). The measured REE, REE/BMR and REE/BMI for patients with inhalation injury were significantly higher than patients without inhalation injury (p<0.01). The measured REE, REE/BMR and REE/BMI for patient needs ventilator were significantly higher than the other group (p<0.01).
CONCLUSION
Indirect calorimetry is useful in detecting variations in energy expenditure among individuals and in detecting changes in metabolism. Unlike indirect calorimetry measurements, static formulas may not consider hypermetabolic and catabolic states. Because adequate nutritional support is essential in burned patients, it should be considered the factors influencing resting energy expenditure on major burn patients.