The influence of age and gender on resting energy expenditure in severely burned children.
BACKGROUND
Recent evidence suggests that female severely burned children have higher endogenous anabolic hormone levels and a shorter ICU stay compared with males. The purpose of this study was to analyze the influence of age and gender on resting energy expenditure (REE) in severely burned children from acute hospitalization through 12 months postburn.


METHODS
A total of 100 pediatric patients with > 40% total body surface area (TBSA) burn were enrolled in a prospective study and followed by indirect calorimetry measurements. The REE was expressed as actual REE kcal/d, percent of predicted REE, and REE/ body mass index (BMI). Statistical analysis was performed by Student t test and one-way ANOVA for repeated measures. Significance was accepted at P < 0.05.


RESULTS
The measured REE was significantly higher in males versus females at all time points (P < 0.05). The percent of predicted REE was significantly higher in males versus females during the acute hospitalization, at discharge, 6 and 9 months postburn (P < 0.05). The REE/BMI showed a significant difference between males and females at the acute and discharge time period (P < 0.05). In children 3 to 9.9 years of age, the measured REE and the percent of predicted REE were significantly higher in males versus females during the acute study, at discharge and 6 months postburn (P < 0.05). The measured REE at discharge, 9 and 12 months postburn for children >10 years of age was significantly higher in males compared with females (P < 0.05).


CONCLUSIONS
Data show that female children exert a decreased hypermetabolic response compared with male children, which may improve burn outcomes in females.
Mlcak
Ronald P
RP
Shriners Hospital for Children and Department of Surgery, University Texas Medical Branch, Galveston, TX 77550, USA. rmlcak@utmb.edu
Jeschke
Marc G
MG
Barrow
Robert E
RE
Herndon
David N
DN
D000293:Adolescent; D000367:Age Factors; D001830:Body Surface Area; D002056:Burns / Q000378:metabolism* / Q000473:pathology; D002153:Calorimetry, Indirect; D002648:Child; D002675:Child, Preschool; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D012727:Sex Characteristics