Balance of Energy Producing Substrates

Energy requirements may be met by glucose, fat, and protein. There has been much interest in the relative proportions of these three sources, and it now seems that 20-25% should be supplied as protein but only 15% as fat.

Table 4 Examples of formulas used to predict energy requirements in children

Wolfea

BMR x 2 kcal/24 h

Males BMR equation Females BMR equation

Modified Galveston formulas''

Less than 1 year old: 2100kcal/m2 BSA + 1000kcal/m2 BSA burned

Less than 12years old: 1800kcal/m2 BSA + 1300kcal/m2 BSA burned

12-18years old: 1500kcal/m2 BSA + 1500kcal/m2 BSA burned

Curreri junior formulas0

Daily calorie needsd Birth-1year: basal RDA in kcal + (15kcal/% burn) 1-3years: basal RDA in kcal + (25kcal/% burn) 4-15years: basal RDA in kcal + (40kcal/% burn)

aO'Neil CE, Hutsler D, and Hildreth MA. Basic nutritional guidelines for pediatric burn patients. Journal of Burn Care & Rehabilitation. 1989, 10(3): 278-84.

bHildreth MA, Herndon DN, Desai MH, and Duke MA. Reassessing caloric requirements in pediatric burn patients. Journal of Burn Care Rehabiiitation 1988, 9(6): 616-8.

cDay T, Dean P, Adams MC, Luterman A, Ramenofsky ML, and Curreri PW. Nutritional requirements of the burned child: the Curreri junior formula. Proceedings of the American Burn Association 1986, 18: 86.

dRDA (kcal) varies with age: 0-0.5years, 320; 0.5-1 years, 500; 1-3years, 740; 4-6years, 950; 7-10years, 1130; 11-14years, 1440 (male) and 1310 (female); 15-18 years, 1760 (male) and 1370 (female).

BMR, basal metabolic rate; BSA, body surface area; RDA, recommended daily allowance; W, weight in kilograms.

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