Abstract / Summary
Severe burn injury produces a combined hypermetabolic, inflammatory, and toxemic response that increases cardiac workload. This study evaluated age- and severity-related changes in a calculated myocardial oxygen-demand index, defined as heart rate × systolic arterial pressure / 100, and its associations with laboratory manifestations of endogenous intoxication in children with burn toxemia. The analysis included 76 children from a cohort of 102 patients with severe thermal burns: 31 aged 6 months-3 years, 20 aged 3.1-7 years, and 25 aged 7.1-18 years. Each age group was divided into three severity subgroups according to the duration of treatment in the intensive care unit. The calculated myocardial oxygen-demand index remained elevated throughout toxemia, with different age- and severity-related trajectories. Inverse associations between the calculated myocardial oxygen-demand index and erythrocytes, hemoglobin, and hematocrit were reported in several pediatric strata, while inflammatory-cell activation, pancreatic diastase, alanine aminotransferase, and selected coagulation variables were associated with unfavorable shifts in the calculated index in specific subgroups. Medium-molecular-weight peptides were strongly correlated with leukocyte count in children younger than 7 years during days 5-12 (r=0.79-0.99), although a direct correlation between the calculated myocardial oxygen-demand index and medium-molecular-weight peptides was not reported. These findings support combined hemodynamic and laboratory monitoring during pediatric burn toxemia.