TY - JOUR
T1 - Gender differences in pediatric burn patients
T2 - Does it make a difference?
AU - Jeschke, Marc G.
AU - Mlcak, Ronald P.
AU - Finnerty, Celeste C.
AU - Norbury, William B.
AU - Przkora, Rene
AU - Kulp, Gabriela A.
AU - Gauglitz, Gerd G.
AU - Zhang, Xiao Jun
AU - Herndon, David N.
PY - 2008/7
Y1 - 2008/7
N2 - OBJECTIVE:: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. SUMMARY BACKGROUND DATA:: One-hundred eighty-nine children sustaining a 40% total body surface area burn were divided into females (n = 76) and males (n = 113). METHODS:: Patient emographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. RESULTS:: There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29±3 days whereas the stay in males was 38±3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028±0.001% vs. males: -0.05±0.007%) and an increase in lean body mass (Δ females: 5±4% vs. Δ males: -1±3%), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. CONCLUSIONS:: Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.
AB - OBJECTIVE:: There is evidence that females have a better outcome in intensive care units (ICUs) when compared with males. The aim of the present study was to compare hospital course and physiologic markers between severely burned pediatric females and males. SUMMARY BACKGROUND DATA:: One-hundred eighty-nine children sustaining a 40% total body surface area burn were divided into females (n = 76) and males (n = 113). METHODS:: Patient emographics, clinical parameters, and mortality were noted. Muscle protein synthesis was determined by stable isotope technique. Resting energy expenditure (REE) was measured by indirect calorimetry and body composition by dual x-ray absorptiometry. Serum hormones, proteins, and cytokines were determined. Cardiac function and liver size were determined by repeated ultrasound measurements. RESULTS:: There were no significant differences between females and males for mortality, demographics, burn size, nutritional intake, or concomitant injuries. ICU stay was in females: 29±3 days whereas the stay in males was 38±3 days, P < 0.05. Females had a significant attenuated loss in muscle protein net balance (females: -0.028±0.001% vs. males: -0.05±0.007%) and an increase in lean body mass (Δ females: 5±4% vs. Δ males: -1±3%), P < 0.05. Percent-predicted REE was significantly decreased in females compared with males, P < 0.05. Systemic inflammatory markers and stress hormone levels were significantly decreased in females, P < 0.05. Cardiac and liver dysfunction were significantly attenuated in females compared with males, P < 0.05. CONCLUSIONS:: Female burned patients exert an attenuated inflammatory and hypermetabolic response compared with males. This decrease is reflected in improved muscle protein net balance and preservation of lean body mass, which are associated with shortened hospital stay.
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U2 - 10.1097/SLA.0b013e318176c4b3
DO - 10.1097/SLA.0b013e318176c4b3
M3 - Article
C2 - 18580216
AN - SCOPUS:48949118880
SN - 0003-4932
VL - 248
SP - 126
EP - 136
JO - Annals of surgery
JF - Annals of surgery
IS - 1
ER -