Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here to sign up for SAGE Journal Email Alerts today!

Sign In to gain access to subscriptions and/or personal tools.
Journal of Parenteral and Enteral Nutrition
This Article
Right arrow Full Text (OnlineFirst PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Branski, L. K.
Right arrow Articles by Jeschke, M. G.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Branski, L. K.
Right arrow Articles by Jeschke, M. G.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Article

Measurement of Body Composition in Burned Children: Is There a Gold Standard?

Ludwik K. Branski, MD1, William B. Norbury, MD2, David N. Herndon, MD, FACS1, David L. Chinkes, PhD1, Amalia Cochran, MD2, Oscar Suman, PhD1, Deb Benjamin, RN2, and Marc G. Jeschke, MD, PhD1*

1 University of Texas Medical Branch; Shriners Hospitals for Children
2 Shriners Hospitals for Children

* To whom correspondence should be addressed. E-mail: majeschk{at}utmb.edu.


  Abstract
Background: Maintaining lean body mass (LBM) after a severe burn is an essential goal of modern burn treatment. An accurate determination of LBM is necessary for short- and longterm therapeutic decisions. The aim of this study was to compare 2 measurement methods for body composition, wholebody potassium counting (K count) and dual x-ray absorptiometry (DEXA), in a large prospective clinical trial in severely burned pediatric patients. Methods: Two-hundred seventy-nine patients admitted with burns covering 40% of total body surface area (TBSA) were enrolled in the study. Patients enrolled were controls or received long-term treatment with recombinant human growth hormone (rhGH). Near-simultaneous measurements of LBM with DEXA and fat-free mass (FFM) with K count were performed at hospital discharge and at 6, 9, 12, 18, and 24 months post injury. Results were correlated using Pearson’s regression analysis. Agreement between the 2 methods was analyzed with the Bland-Altman method. Results: Age, gender distribution, weight, burn size, and admission time from injury were not significantly different between control and treatment groups. rhGH and control patients at all time points postburn showed a good correlation between LBM and FFM measurements (R2 between 0.9 and 0.95). Bland-Altman revealed that the mean bias and 95% limits of agreement depended only on patient weight and not on treatment or time postburn. The 95% limits ranged from 0.1 ± 2.9 kg for LBM or FFM in 7- to 18-kg patients to 16.3 ± 17.8 kg for LBM or FFM in patients >60 kg. Conclusions: DEXA can provide a sufficiently accurate determination of LBM and changes in body composition, but a correction factor must be included for older children and adolescents with more LBM. DEXA scans are easier, cheaper, and less stressful for the patient, and this method should be used rather than the K count. (JPEN J Parenter Enteral Nutr. XXXX;xx:xx-xx)

First published on November 2, 2009
Journal of Parenteral and Enteral Nutrition 2009, doi:10.1177/0148607109336601
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?