Acute changes in oxygen consumption and body temperature after burn injury

This study describes the pattern of oxygen consumption (VαEO 2), rectal temperature (T(r)), and acral skin temperature (T(ac)) in sleeping and resting (awake) burned children nursed in a thermoneutral environment. Measurements of respiratory gas exchange (VαEO 2 and carbon dioxide production (VαECO 2)) were made using an open circuit, flow through system of indirect calorimetry. T(r) and T(ac) were monitored continuously. Sixteen patients were studied during the first 18 hours after being burned. Three phases of change in VαEO 2, T(r), and T(ac) are described. The first was a stable period and there was Little change from admission values. The second (7-10 hours after burn) was a phase of rapid heat storage. It started with a fall in T,,. Peak values of T(r) (38.8-41.1, median 40.0°C) and VαEO 2 (8.5-11.8 ml/min/kg) occurred either in phase 2 or in the later phase 3. At its peak VαEO 2 was 12-61% above values in phase 1. In phase 3, T(ac) returned towards admission values but T(r) and VαEO 2 were variable. These changes suggest that both an increase in metabolic heat production as well as heat conservation at the extremities may be involved in the generation of early fever after a burn.