Emergency Treatment of Severely Burned Pediatric Patients: Current Therapeutic Strategies

Gerd G. Gauglitz; David N. Herndon; Marc G. Jeschke


Pediatr Health. 2008;2(6):761-775. 

In This Article

Long-term Responses

Despite adequate and rapid treatment immediately, postburn injury is associated with long-term consequences. Recent studies demonstrate that inflammation, hypermetabolism, catecholamines and cortisol are increased for up to 3 years postburn [Jeschke MG et al., Unpublished Data]. These data indicate the local and systemic effects of a burn are not limited to the 95% healed stage. A burn continues to plague and impair patients over a prolonged time. The Glue grant group investigated in a recent study the persistence of genomic changes after burn and found that the genome of white blood cells is altered for up 12 months postburn, indicating the profound changes with a burn injury.[133,134] We therefore initiated several studies to determine whether the long-term effects can be alleviated.[17,76,93,100,107] We found that administration of anabolic agents, such as oxandrolone, growth hormone or propranolol, can improve long-term outcomes. Furthermore, in an unpublished study we found that exercise can tremendously improve strength and rehabilitation of severely burned patients. In summary, a burn is not limited to the acute phase. It is a process that continues over a long time and requires a patient-specific treatment plan in order to improve patient outcome.


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