title: Sodium bromide by instrumental neutron activation analysis quantifies change in extracellular water space with wound closure in severely burned children.
abstract: BACKGROUND
  The ability to measure extracellular water (ECW) in critically ill patients can significantly enhance current methods of assessing fluid homeostasis, body composition, and response to nutritional therapy. We measured corrected bromide space to determine change in ECW with wound closure among acutely burned children.
  
  
  METHODS
  Fifteen children with burns over 30% of their total body surface area had their ECW determined following hemodynamic stabilization and when wound closure was complete. Plasma samples were obtained at baseline and 4 hours after receiving 25 mg/kg of sodium bromide. Plasma bromide was quantified by instrumental neutron activation analysis.
  
  
  RESULTS
  Mean CBS decreased with wound closure (9.1 +/- 4.1 vs 7.9 +/- 3.9 liters; P =.04), indicating a significant decrease in ECW over the course of recovery. A decline in weight also occurred over the same period (32.4 +/- 15.2 vs 29.1 +/- 13.5 kg; P =.007); however, change in corrected bromide space as a proportion of weight was not statistically significant.
  
  
  CONCLUSIONS
  A significant decrease in ECW accompanies the weight loss observed in patients following wound closure. Measurement of bromide dilution space is a convenient method for monitoring ECW that can be done at the bedside.
authors.affiliation: Nutrition Support, Shriners Hospitals for Children, 51 Blossom Street, Boston, MA 02114, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Prelack
authors.forename: Robert
authors.initials: R
authors.lastname: Sheridan
authors.forename: Yong-Ming
authors.initials: YM
authors.lastname: Yu
authors.forename: Ion E
authors.initials: IE
authors.lastname: Stamatelatos
authors.forename: Johanna
authors.initials: J
authors.lastname: Dwyer
authors.forename: Gerard E
authors.initials: GE
authors.lastname: Dallal
authors.forename: Martha
authors.initials: M
authors.lastname: Lydon
authors.forename: Lisa
authors.initials: L
authors.lastname: Petras
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Kehayias
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001823:Body Composition; D001965:Bromides / Q000032:analysis / Q000097:blood; D002056:Burns / Q000175:diagnosis* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005110:Extracellular Space / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009501:Neutron Activation Analysis; D012463:Saliva / Q000737:chemistry; D012720:Severity of Illness Index; D017670:Sodium Compounds / Q000032:analysis / Q000097:blood; D014867:Water / Q000378:metabolism; D014882:Water-Electrolyte Balance; D014945:Wound Healing; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D001965:Bromides; D017670:Sodium Compounds; D014867:Water; C027938:sodium bromide