Gender Differences in Pediatric Burn Patients

Jeschke, Marc G.; Mlcak, Ronald P.; Finnerty, Celeste C.; Norbury, William B.; Przkora, René; Kulp, Gabriela A.; Gauglitz, Gerd G.; Zhang, Xiaojun; Herndon, David N.

doi:10.1097/sla.0b013e318176c4b3

Cited by 149 publications

(45 citation statements)

References 33 publications

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“…However, in children with burns (8 years of age on average), females had a less negative net muscle protein balance compared to males, and females gained lean body mass whereas males lost lean body mass. These differences were possibly due to the observed attenuated hypermetabolic response in females 41. Assuming that the same differences are true for critically ill infants, this would mean that the achievement of protein anabolism in the first days after admission in our study population could have been biased by the high proportion of females.…”

Section: Discussionmentioning

confidence: 89%

“…However, gender differences in protein kinetics have not been described for critically ill infants. Moreover, our study population of infants with a viral infection is distinctly different from children with burns, who are subject to an extended hypermetabolic stress response with high inflammation 41. Also, when comparing the female with the male subjects within the PE- and S-groups of our study, the only notable difference was a non-significant trend towards higher protein turnover, synthesis and breakdown in the females compared to the males within the PE-group, but resulting in similar protein balances in both sexes.…”

Section: Discussionmentioning

confidence: 99%

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Increased protein-energy intake promotes anabolism in critically ill infants with viral bronchiolitis: a double-blind randomised controlled trial

Betue

Waardenburg

Deutz

et al. 2011

Archives of Disease in Childhood

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ObjectiveThe preservation of nutritional status and growth is an important aim in critically ill infants, but difficult to achieve due to the metabolic stress response and inadequate nutritional intake, leading to negative protein balance. This study investigated whether increasing protein and energy intakes can promote anabolism. The primary outcome was whole body protein balance, and the secondary outcome was first pass splanchnic phenylalanine extraction (SPEPhe).DesignThis was a double-blind randomised controlled trial. Infants (n=18) admitted to the paediatric intensive care unit with respiratory failure due to viral bronchiolitis were randomised to continuous enteral feeding with protein and energy enriched formula (PE-formula) (n=8; 3.1±0.3 g protein/kg/24 h, 119±25 kcal/kg/24 h) or standard formula (S-formula) (n=10; 1.7±0.2 g protein/kg/24 h, 84±15 kcal/kg/24 h; equivalent to recommended intakes for healthy infants <6 months). A combined intravenous-enteral phenylalanine stable isotope protocol was used on day 5 after admission to determine whole body protein metabolism and SPEPhe.ResultsProtein balance was significantly higher with PE-formula than with S-formula (PE-formula: 0.73±0.5 vs S-formula: 0.02±0.6 g/kg/24 h) resulting from significantly increased protein synthesis (PE-formula: 9.6±4.4, S-formula: 5.2±2.3 g/kg/24 h), despite significantly increased protein breakdown (PE-formula: 8.9±4.3, S-formula: 5.2±2.6 g/kg/24 h). SPEPhe was not statistically different between the two groups (PE-formula: 39.8±18.3%, S-formula: 52.4±13.6%).ConclusionsIncreasing protein and energy intakes promotes protein anabolism in critically ill infants in the first days after admission. Since this is an important target of nutritional support, increased protein and energy intakes should be preferred above standard intakes in these infants.Dutch Trial Register number: NTR 515.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Increased protein-energy intake promotes anabolism in critically ill infants with viral bronchiolitis: a double-blind randomised controlled trial

Betue

Waardenburg

Deutz

et al. 2011

Archives of Disease in Childhood

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“…Taken together, these results suggest that 12-week fFl rats respond to the 20% TBSA burn to an intermediate degree compared with the other two groups. The effects of strain 19 could be further investigated as a function of gender, 8,30 as well as body size and percent fat mass composition. 31,32 …”

Section: Discussionmentioning

confidence: 99%

Effects of Burn Injury on Markers of Hypermetabolism in Rats

Izamis

Uygun

et al. 2009

Journal of Burn Care & Research

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The basic metrics of hypermetabolism have not been thoroughly characterized in rat burn injury models. We examined three models expected to differ in sensitivity to burn injury to identify that which group(s) exhibited the most clinically relevant metabolic response. Six and 12 weeks old male CD (6 week mCD and 12 week mCD) rats, and 12 weeks old female Fischer (12 week fFI) rats received a 20% total body surface area burn, followed by saline resuscitation. Activity, core body temperature, heart rate (via implanted telemetry devices), body weight, food and water intake, and fecal output were measured daily for 1 week before and after burn. Rats lost weight initially postburn but resumed weight gain by 1 week, except for 12 week mCD rats. Core body temperature increased above normal 2 days postburn and returned to baseline by 1 week. Food intake, normalized to body weight, remained unchanged postburn for 12 week mCD rats, but decreased in 6 week mCD rats and increased in 12 week fFI rats. Heart rate in the 12 week mCD and 12 week fFI rats remained at 10 to 15% above baseline, whereas, in 6 week mCD, heart rates returned to baseline after 4 days. Activity levels were unchanged for 12 week fFI and 6 week mCD rats postburn, but decreased for 12 week mCD rats. Postburn hypermetabolism was most significant and sustained in 12 week mCD rats, of least consequence and brief in 6 week mCD rats, and intermediate in 12 week fFI rats. The disparate responses indicate that the choice of animal model should be carefully considered in hypermetabolism studies.

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“…In the acute phase of burn injuries, pediatric females have reasonably higher levels of anabolic hormones than the male patients, thereby sustaining decreased hypermetabolism and need shorter intensive care unit stay [38]. In another subsequent study, Jeschke et al [39] showed that females have shorter intensive care units (ICUs) and hospital stay than males after severe thermal injury.…”

Section: Introductionmentioning

confidence: 99%

Traumatic injury among females: does gender matter?

El‐Menyar

Hennawy

Al-Thani

et al. 2014

J Trauma Manage Outcomes

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BackgroundTrauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported.AimTo study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women.MethodsWe conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words “trauma”, “gender”, “female” and “women”.ResultsAmong 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported.ConclusionThere is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs.

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Gender Differences in Pediatric Burn Patients

Abstract: 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.

Cited by 149 publications

References 33 publications

Increased protein-energy intake promotes anabolism in critically ill infants with viral bronchiolitis: a double-blind randomised controlled trial

Increased protein-energy intake promotes anabolism in critically ill infants with viral bronchiolitis: a double-blind randomised controlled trial

Effects of Burn Injury on Markers of Hypermetabolism in Rats

Traumatic injury among females: does gender matter?

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