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Measures of Total Energy Expenditure and Its Components Using the Doubly Labeled Water Method in Rehabilitating Burn Children
Author(s) -
Prelack Kathy,
Yu Yong Ming,
Dylewski Maggie,
Lydon Martha,
Keaney Timothy J.,
Sheridan Robert L.
Publication year - 2017
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607115597665
Subject(s) - resting energy expenditure , basal metabolic rate , doubly labeled water , total body surface area , medicine , energy expenditure , anabolism , population , total energy expenditure , body surface area , prospective cohort study , zoology , body weight , surgery , biology , environmental health
Background: A persistent hypermetabolic state delays anabolism and growth in burned children. However, our own clinical experience has been that resting energy expenditure (REE) is not increased during the rehabilitative phase, suggesting other contributing factors. We measured total energy expenditure (TEE) and its components in rehabilitating pediatric burn patients to identify the basis for accelerated energy metabolism in this population. Materials and Methods : Children admitted with initial burns of 20% of their total body surface area (TBSA) or greater were enrolled into this prospective, descriptive study. TEE was measured using the doubly labeled water method over a 7‐day period. During that period, REE was measured on 2 days by indirect calorimetry. Activity energy expenditure (AEE) was assessed using a physical activity monitoring device for a 24‐hour period. TEE and REE were compared with sex‐specific, age‐matched, and weight‐matched norms using the Dietary Reference Intakes (DRI) standards. Results : Ten children with an average burn size of 53.7% ± 20% (range, 27%–82%) of TBSA completed this study. Their mean age and weight were 10.4 ± 5.5 years and 35.8 ± 16.4 kg, respectively. Daily TEE averaged 66 kcal/kg and was 1.08% of reference DRI. REE was 92% ± 25% of predicted basal metabolic rate, not exceeding 120% as a maximum value in any child. Conclusions : TEE and REE in rehabilitating burn children are comparable to reference standards. Increased REE was not typical in our population, but measures of AEE were commonly high.