Energy expenditure in small burns: A pilot study

Janica Bell1, Associate Professor Philippa Lyons-Wall1, Dr Angus Stewart1, Dr Dale Edgar2, Professor Fiona Wood2, Michelle Cork2

1 Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, j.bell@ecu.edu.au
2 Fiona Stanley Hospital, 102 – 118 Murdoch Drive, Murdoch, WA, 6150

Energy expenditure increases following a burn injury. Despite small burns accounting for majority of burn related admissions, their energy expenditure and nutritional status remains unpublished. The aim of this study was to describe the resting energy expenditure (REE) and nutritional status of small burns (< 15% total body surface area (TBSA)). Demographic, anthropometry and dietary data (24 hour recall) was collected for 2 female and 3 male non-ventilated burn patients. REE was determined using indirect calorimetry (Ultima CPX) and compared to REE for major burns in the literature. Mean TBSA was 7±2% (5-9%). Mean body mass index was 26±3 kg/m2 (overweight). Mean REE was 6543±1792 kJ/day, lower than reported REE of major burn populations in the literature (p<0.05). Mean total energy expenditure (TEE) was 9814±2688 kJ/day, calculated from REE utilising a 50% activity factor. Mean energy intake was 8385±1792 kJ/day. At a group level, there was a deficit of 1429±2124kJ/day. At an individual level, there was a range from -4356 kJ/day to 1125 kJ/day. Mean protein intake was 93±19 g/day, all participants met the recommended protein range (1.0-1.5g/kg/day). The cohort experienced a clinically relevant energy deficit however, individual variation was observed. Determination of TEE is challenging, with reliance on activity factors and single day diet analyses. Small burns patients warrant individual longitudinal monitoring of nutritional status to avoid chronic energy deficits and associated consequences. Further research is needed to understand energy expenditure of this population, with attention to physical activity in burn rehabilitation and the impact on nutritional status.

Key Words

Burn, thermal injury, indirect calorimetry, resting energy expenditure, resting metabolic rate, nutrition.

Biography

Fiona Wood has been a burns surgeon and researcher for the past 20 years and is Director of the Burns Service of Western Australia (BSWA). She is a Consultant Plastic Surgeon at Fiona Stanley Hospital (previously at Royal Perth Hospital) and Princess Margaret Hospital for Children. She is the current ANZBA President.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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