Nutrition in Pediatric Burns.

Nutrition and modulation of the hypermetabolic response to acute burns are reviewed in this article. Methods to determine caloric requirements are evaluated, including indirect calorimetry and predictive equations. Individual nutritional components of carbohydrates, fat, protein, vitamins, and trace elements are discussed specifically in relation to acute burn care. Selection of formula and route of administration are outlined, with an enteral high-carbohydrate, low-fat diet being preferable. Awareness and recognition of the signs and symptoms of malnutrition is critical in the management of variable caloric needs throughout hospitalization. Lastly, the catabolic state of acute burns is addressed through early excision and grafting and implementation of various pharmacologic agents, including growth hormone, insulin-like growth factor-1, insulin-like growth factor-binding protein-3, insulin, propranolol, and oxandrolone. Through a multipronged approach to nutrition, pediatric burn patients are provided the substrates for successful recovery and rehabilitation.

Inhalation Injury.

Inhalation injury is a critical component of thermal injury that can significantly increase mortality in burn survivors. This poses significant challenges to managing these patients and profoundly impacts patient outcomes. This comprehensive literature review delves into the epidemiology, pathophysiology, diagnosis, classification, management, and outcomes of inhalation injury with burns.

Global Surgery: Burn Outreach by Shriners Children's Texas.

Global surgery describes a rapidly developing field that seeks to improve surgical treatment internationally, specifically in those specialized treatments that are not readily accessible, considered complex and expensive. Burns cause 300,000 deaths annually, 90% of which occur in low- and middle-income countries (LMICs). Burns are a public health problem since they can cause disability and death. Shriners Children's Texas is a unique model of global surgery for an important number of countries in Central and South Americas and Mexico, providing specialized acute burn care with low mortality for burned children. Survivors of severe burns may face devastating sequelae due to burn scar contractures and hypertrophic burn scars that may limit the social reintegration. Burn reconstruction is not easily accessible to patients in LMICs. After discharge from acute burn treatment at our hospital, patients may return every 6 months for in-person follow-up to assess any surgical, psychological, or rehabilitative needs. Telemedicine allows for monitoring of postoperative results and evaluation for new surgical procedures. Follow-up clinic visits called outreach clinics held in international hospitals or international Shriners Temples allow for evaluation of follow-up patients and new patients with reconstructive needs that may benefit from a treatment in Shriners Children's Texas in Galveston, Texas.

Update on Hypermetabolism in Pediatric Burn Patients.

Despite advancements in pediatric burn care, the profound hypermetabolic response associated with severe burns remains a multifaceted challenge throughout the continuum of care. Understanding the various physiologic disturbances that constitute hypermetabolism is crucial for a thorough evaluation and for implementing appropriate surgical and nonsurgical interventions. In this article, we describe the pathophysiology and treatment of hypermetabolism in pediatric burn patients with a focus on reducing resting energy requirements, minimizing infection, and optimizing nutrition for patients undergoing frequent surgical intervention.

Benefits and Process of Providing Peer Support for Pediatric Burn Survivors and Caregivers during Inpatient and Outpatient Phases of Recovery.

The World Health Organization reveals that pediatric burns represent a large portion of burns globally (61). Increases in survival rates have guided clinical and research focus on physical, psychological, and social outcomes. Research on other childhood illnesses has shown the efficacy of social support throughout recovery. In the pediatric burn literature, studies have shown the efficacy of burn camps for promoting positive interactions among survivors, learning coping skills, and facilitating socialization and reintegration. However, few studies have focused on the benefits of peer support for pediatric burn survivors and their caregivers in the inpatient and outpatient phases of recovery. This descriptive paper identifies options for building resilience for pediatric burn survivors through peer support in the inpatient and outpatient phases of recovery. The authors discuss options for providing peer support during the coronavirus disease 2019 pandemic on the pediatric intensive care unit, general pediatric floor, and outpatient setting.