Bone metabolism in pediatric burned patients: A review

• Published in: Burns Vol. 44; no. 8; pp. 1863 - 1869
• Main Authors: Schryver, Eric, Klein, Gordon L., Herndon, David N., Suman, Oscar E., Branski, Ludwik K., Sousse, Linda E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2018
• Subjects: Adaptor Proteins, Signal Transducing; Aluminum; Aluminum - metabolism; Body Composition; Bone and Bones - metabolism; Bone Density; Bone Density Conservation Agents - therapeutic use; Bone metabolism; Bone Morphogenetic Protein 2 - metabolism; Bone morphogenetic protein-2; Bone Morphogenetic Proteins - metabolism; Bone Remodeling; Burns; Burns - metabolism; Calcium; Calcium - metabolism; Child; Collagen Type I - metabolism; Copper - metabolism; Genetic Markers; Glucocorticoids - metabolism; Humans; Magnesium - metabolism; Osteoblasts; Osteocalcin; Osteocalcin - metabolism; Osteoclasts; Osteogenesis; Osteoporosis - prevention & control; Pamidronate - therapeutic use; Parathyroid hormone; Parathyroid Hormone - metabolism; Sclerostin; Type I collagen; Urine free cortisol; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - metabolism; Vitamin D - therapeutic use; Zinc - metabolism; Bone morphogenetic protein-2; Osteocalcin; Vitamin D; Calcium; Aluminum; Parathyroid hormone; Sclerostin; Burns; Type I collagen; Bone metabolism; Urine free cortisol
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2018.04.014

•This review examines 11 randomized, placebo-controlled prospective clinical trials in pediatric burns between 1995 and 2017, which include approximately 250 burned pediatric subjects in total.•These studies were conducted to evaluate the impact of burn injury on markers of bone formation and bone metabolism, and some trials analyzed current therapy regimens such as pamidronate and vitamin D.•It is recommended that all children, following hospital discharge after receiving treatment for severe burn injury, should receive, at a minimum, a daily dose of multivitamin that contains 400 IU/day of vitamin D. Severe burns in children can lead to growth delays, bone loss, and wasting of lean body mass and muscle with subsequent long-term effects such as osteoporosis. The following review examines 11 randomized, placebo-controlled, prospective clinical trials in pediatric burns between 1995 and 2017. These studies included approximately 250 burned children, and they were conducted to evaluate the impact of severe burn on markers of bone formation and bone metabolism. Some trials also analyzed current therapy regimens such as pamidronate and vitamin D. The clinical utility of these outlined biomarkers is uncertain with regard to acute burn care, as the current literature remains unclear. This review thus serves to address the impact of severe burn on markers of bone formation and bone metabolism in pediatric patients but will not focus on the clinical utility of the markers. The aim of this review is to summarize the findings of the trials to guide the future care of burned patients to maximize bone recovery.