Energy requirements of pediatric patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.
BACKGROUND
The primary purpose of this study was to compare the measured resting energy requirements (MREE) of children with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) with that of children with burns of similar size. A secondary goal was to develop a predictive equation useful in estimating the energy of children with SJS/TEN.


METHODS
This retrospective study included 30 patients admitted to our pediatric burn unit between 12/91 and 03/06. All patients were admitted within 10 days of injury and had at least 1 metabolic cart measurement. Fifteen patients with SJS/TEN comprised group 1. Group 2 consisted of 15 burn patients matched for total wound size, age, preinjury weight, and gender. Caloric intake and discharge weight (percent of preburn weight) were recorded.


RESULTS
The energy needs of the SJS/TEN group were 22% less than the burn group. Correlation between MRE x 1.3 and caloric intake was 0.89 for the SJS/TEN group and 0.92 for the burn group (P < .0001). Both the SJS/TEN and burn groups were managed by nutrition goals based on the MREE x 1.3, and patients were 95.1% +/- 6.3% and 98.9% +/- 6% of preinjury weight at discharge, respectively, in each group. An equation for the estimation of energy requirements in pediatric SJS/TEN patients was statistically generated: (24.6 x weight in kg) + (% wound x 4.1) + 940.


CONCLUSIONS
The energy requirement in pediatric SJS/TEN patients is less than that following burn injury. The application of a 30% factor to MREE is supported in SJS/TEN and thermal injury.
Shriners Hospitals for Children, Nutrition Services, 3229 Burnet Ave, Cincinnati, OH 45229-3018, USA. smsmith@shrinenet.org
Theresa
T
Mayes
Michele
M
Gottschlich
Jane
J
Khoury
Petra
P
Warner
Richard
R
Kagan
D001481:Basal Metabolism / Q000502:physiology*; D002056:Burns / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002149:Energy Intake / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009751:Nutritional Requirements; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000378:metabolism*