Date of Award

2015

Degree Type

Thesis

Degree Name

Bachelor of Health Science Honours

School

School of Exercise & Health Sciences

Faculty

Faculty of Health, Engineering and Science

First Advisor

Associate Professor Phillipa Lyons-Wall

Second Advisor

Dr Angus Stewart

Abstract

Background: Energy expenditure increases following a burn injury. The extent of hypermetabolism is dependent on a range of factors including burn total body surface area. Moderate to low burn injuries (< 15% TBSA) represent majority of hospital admissions for burn injuries however, their energy expenditure remains unpublished. While indirect calorimetry (IC) is the gold standard for determining energy requirements, less accurate predictive equations are often used in practice. Acceptability of IC from a burn patient perspective has not been published.

Aim: To describe the resting energy expenditure (REE) of patients with a moderate to low burn injury using IC; compare measured REE to predictive equations; and determine the patient acceptability of IC.

Methods: Demographic, anthropometric and dietary data were collected for five male and three female burn patients. REE was determined using indirect calorimetry (Ultima CPX) and five predictive methods (Schofield, Harris-Benedict, Toronto and the Ireton-Jones equations, and energy-per-kilogram formulae). A written questionnaire assessed patient acceptability. Results: Mean measured REE was 6494 ± 1625 kJ/day, lower than reported REE of major burn populations from the literature (p < 0.05). At a group level, the Schofield and Toronto equation were accurate to within ± 10% of the measured REE with a mean difference of 5.21 ± 12.16% and 8.89 ± 12.64%, respectively. At an individual level, the Schofield equation was accurate for 67% of participants and overestimated REE for 33% of participants. The Toronto equation was accurate for 50% of participants and overestimated REE for 50% of participants. IC was acceptable from a patient perspective with all participants willing to repeat the measure.

Conclusions: Results of this study support routine use of IC in moderate to low burn injuries, as it is acceptable to patients and avoids the inaccuracies of predictive equations. Where IC is not available, results suggest that the Schofield equation be used with caution to estimate REE for moderate to low burn injuries. Given the small sample size of this study, further research on the REE of moderate to low burn injuries is warranted.

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