Sodium bromide by instrumental neutron activation analysis quantifies change in extracellular water space with wound closure in severely burned children.
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.
Prelack
Kathy
K
Nutrition Support, Shriners Hospitals for Children, 51 Blossom Street, Boston, MA 02114, USA.
Sheridan
Robert
R
Yu
Yong-Ming
YM
Stamatelatos
Ion E
IE
Dwyer
Johanna
J
Dallal
Gerard E
GE
Lydon
Martha
M
Petras
Lisa
L
Kehayias
Joseph J
JJ
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
D001965:Bromides; D017670:Sodium Compounds; D014867:Water; C027938:sodium bromide