Body Composition Changes in Severely Burned Children during ICU Hospitalization

Janos Cambiaso-Daniel, Ioannis Malagaris, Eric Rivas, Gabriel Hundeshagen, Charles D. Voigt, Elizabeth Blears, Ron P. Mlcak, David Herndon, Celeste Finnerty, Oscar Suman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: Prolonged hospitalization due to burn injury results in physical inactivity and muscle weakness. However, how these changes are distributed among body parts is unknown. The aim of this study was to evaluate the degree of body composition changes in different anatomical regions during ICU hospitalization. Design: Retrospective chart review. Setting: Children's burn hospital. Patients: Twenty-four severely burned children admitted to our institution between 2000 and 2015. Interventions: All patients underwent a dual-energy x-ray absorptiometry within 2 weeks after injury and 2 weeks before discharge to determine body composition changes. No subject underwent anabolic intervention. We analyzed changes of bone mineral content, bone mineral density, total fat mass, total mass, and total lean mass of the entire body and specifically analyzed the changes between the upper and lower limbs. Measurements and Main Results: In the 24 patients, age was 10 ± 5 years, total body surface area burned was 59% ± 17%, time between dual-energy x-ray absorptiometries was 34 ± 21 days, and length of stay was 39 ± 24 days. We found a significant (p < 0.001) average loss of 3% of lean mass in the whole body; this loss was significantly greater (p < 0.001) in the upper extremities (17%) than in the lower extremities (7%). We also observed a remodeling of the fat compartments, with a significant whole-body increase in fat mass (p < 0.001) that was greater in the truncal region (p < 0.0001) and in the lower limbs (p < 0.05). Conclusions: ICU hospitalization is associated with greater lean mass loss in the upper limbs of burned children. Mobilization programs should include early mobilization of upper limbs to restore upper extremity function.

Original languageEnglish (US)
Pages (from-to)e598-e605
JournalPediatric Critical Care Medicine
Volume18
Issue number12
DOIs
StatePublished - Dec 1 2017

Fingerprint

Body Composition
Upper Extremity
Hospitalization
Lower Extremity
Fats
Bone Density
X-Rays
Early Ambulation
Body Surface Area
Muscle Weakness
Wounds and Injuries
Human Body
Length of Stay

Keywords

  • exercise
  • lower extremity
  • patient discharge
  • rehabilitation
  • upper extremity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Cambiaso-Daniel, J., Malagaris, I., Rivas, E., Hundeshagen, G., Voigt, C. D., Blears, E., ... Suman, O. (2017). Body Composition Changes in Severely Burned Children during ICU Hospitalization. Pediatric Critical Care Medicine, 18(12), e598-e605. https://doi.org/10.1097/PCC.0000000000001347

Body Composition Changes in Severely Burned Children during ICU Hospitalization. / Cambiaso-Daniel, Janos; Malagaris, Ioannis; Rivas, Eric; Hundeshagen, Gabriel; Voigt, Charles D.; Blears, Elizabeth; Mlcak, Ron P.; Herndon, David; Finnerty, Celeste; Suman, Oscar.

In: Pediatric Critical Care Medicine, Vol. 18, No. 12, 01.12.2017, p. e598-e605.

Research output: Contribution to journalArticle

Cambiaso-Daniel, J, Malagaris, I, Rivas, E, Hundeshagen, G, Voigt, CD, Blears, E, Mlcak, RP, Herndon, D, Finnerty, C & Suman, O 2017, 'Body Composition Changes in Severely Burned Children during ICU Hospitalization', Pediatric Critical Care Medicine, vol. 18, no. 12, pp. e598-e605. https://doi.org/10.1097/PCC.0000000000001347
Cambiaso-Daniel J, Malagaris I, Rivas E, Hundeshagen G, Voigt CD, Blears E et al. Body Composition Changes in Severely Burned Children during ICU Hospitalization. Pediatric Critical Care Medicine. 2017 Dec 1;18(12):e598-e605. https://doi.org/10.1097/PCC.0000000000001347
Cambiaso-Daniel, Janos ; Malagaris, Ioannis ; Rivas, Eric ; Hundeshagen, Gabriel ; Voigt, Charles D. ; Blears, Elizabeth ; Mlcak, Ron P. ; Herndon, David ; Finnerty, Celeste ; Suman, Oscar. / Body Composition Changes in Severely Burned Children during ICU Hospitalization. In: Pediatric Critical Care Medicine. 2017 ; Vol. 18, No. 12. pp. e598-e605.
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abstract = "Objectives: Prolonged hospitalization due to burn injury results in physical inactivity and muscle weakness. However, how these changes are distributed among body parts is unknown. The aim of this study was to evaluate the degree of body composition changes in different anatomical regions during ICU hospitalization. Design: Retrospective chart review. Setting: Children's burn hospital. Patients: Twenty-four severely burned children admitted to our institution between 2000 and 2015. Interventions: All patients underwent a dual-energy x-ray absorptiometry within 2 weeks after injury and 2 weeks before discharge to determine body composition changes. No subject underwent anabolic intervention. We analyzed changes of bone mineral content, bone mineral density, total fat mass, total mass, and total lean mass of the entire body and specifically analyzed the changes between the upper and lower limbs. Measurements and Main Results: In the 24 patients, age was 10 ± 5 years, total body surface area burned was 59{\%} ± 17{\%}, time between dual-energy x-ray absorptiometries was 34 ± 21 days, and length of stay was 39 ± 24 days. We found a significant (p < 0.001) average loss of 3{\%} of lean mass in the whole body; this loss was significantly greater (p < 0.001) in the upper extremities (17{\%}) than in the lower extremities (7{\%}). We also observed a remodeling of the fat compartments, with a significant whole-body increase in fat mass (p < 0.001) that was greater in the truncal region (p < 0.0001) and in the lower limbs (p < 0.05). Conclusions: ICU hospitalization is associated with greater lean mass loss in the upper limbs of burned children. Mobilization programs should include early mobilization of upper limbs to restore upper extremity function.",
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