Impaired zinc and copper status in children with burn injuries: Need to reassess nutritional requirements

Voruganti, V. Saroja; Klein, Gordon L.; Lu, Hong-Xing; Thomas, Suchmor; Freeland-Graves, Jeanne H.; Herndon, David N.

doi:10.1016/j.burns.2005.04.026

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Volume 31, Issue 6 , Pages 711-716, September 2005

Impaired zinc and copper status in children with burn injuries: Need to reassess nutritional requirements

V. Saroja Voruganti
- Division of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
Gordon L. Klein
- Department of Pediatrics, Galveston, TX, USA
- University of Texas Medical Branch and Shriners Burns Hospital, Children's Hospital, Room 3.270, 301 University Boulevard, Galveston, TX 77555-0352, USA
- Corresponding author. Tel.: +1 409 772 1689; fax: +1 409 747 2213.
Hong-Xing Lu
- Division of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
Suchmor Thomas
- Department of Surgery, Galveston, TX, USA
- University of Texas Medical Branch and Shriners Burns Hospital, Children's Hospital, Room 3.270, 301 University Boulevard, Galveston, TX 77555-0352, USA
Jeanne H. Freeland-Graves
- Division of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
David N. Herndon
- Department of Surgery, Galveston, TX, USA
- University of Texas Medical Branch and Shriners Burns Hospital, Children's Hospital, Room 3.270, 301 University Boulevard, Galveston, TX 77555-0352, USA

Accepted 29 April 2005.

Abstract

Major burns are associated with impaired Zn and Cu status. These micronutrients are essential for bone matrix formation, linear growth, and wound healing. This study evaluated the status of Zn and Cu in burned children and assessed adequacy of supplementation. Six children, mean total body surface area (TBSA), 54±9% (S.D.), were recruited. Nutrient intakes, plasma, wound exudate, and 24h urine samples were collected and analyzed for Zn and Cu. Bone mineral content was assessed by dual energy X-ray absorptiometry. Dietary Zn and Cu were three times the dietary reference, and mean plasma concentrations of Zn and Cu were low at admission and discharge. Urinary Zn was elevated at admission, whereas Cu was elevated at both times. Wound Zn and Cu concentrations exceeded plasma concentrations, suggesting that inflammatory wound exudate was a primary route of loss. We demonstrate that burn injury in children results in low plasma levels of Zn and Cu that are inadequately compensated during hospitalization.