title: Energy and protein provisions for thermally injured children revisited: an outcome-based approach for determining requirements.
abstract: Energy and protein provisions for adequate wound healing and weight maintenance were examined among severely burned children. Actual intakes were documented for 27 patients admitted with a more than 40% total body surface area burn. Mean energy intake over the 4-week study period averaged 140% of the predicted basal metabolic rate (PBMR), and mean protein intake was 2.8 +/- 0.2 grams per kilogram daily. Wound healing progressed satisfactorily in all patients; at 4 weeks, the open wound area (% open) was 20% or less in 22 patients. Average weight at discharge was 88% +/- 2.6% of ideal body weight. Discharge weights were significantly higher (p < 0.05) among patients whose energy intake exceeded PBMR x 1.7 for at least 1 of the study weeks. We suggest that energy intakes approximating PBMR x 1.2 with a minimum of 3 grams of protein per kilogram will support adequate wound healing, whereas higher energy provisions (PBMR x 1.7) will enhance weight status.
authors.affiliation: Shriners Burns Institute-Boston Unit, Massachusetts General Hospital 02114, USA.
authors.forename: K
authors.initials: K
authors.lastname: Prelack
authors.forename: J J
authors.initials: JJ
authors.lastname: Cunningham
authors.forename: R L
authors.initials: RL
authors.lastname: Sheridan
authors.forename: R G
authors.initials: RG
authors.lastname: Tompkins
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002056:Burns / Q000534:rehabilitation*; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D006801:Humans; D009751:Nutritional Requirements; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D004044:Dietary Proteins