A PROSPECTIVE ANALYSIS OF SERUM VITAMIN-K IN SEVERELY BURNED PEDIATRIC-PATIENTS

Patients with burn injuries exhibit multiple risk factors for the deve lopment of vitamin K deficiency, including malabsorption, limited ente ral intake, antibiotic therapy, and multiple surgical procedures. A pr ospective evaluation of 48 children was conducted to evaluate serum vi tamin K values during the first 4 postburn weeks. Serum levels were an alyzed in relation to clinical course. Days of antibiotic (p < 0.02) a nd albumin therapy (p < 0.003), percentage body surface area excised ( p < 0.006), and the administration of blood products (p < 0.05) were s ignificantly correlated with serum vitamin K levels, and days of diarr hea approached statistical significance (p < 0.06). No relationship wa s found between serum values and prothrombin time, activated partial t hromboplastin time, or serum albumin. Ninety-one percent of the childr en demonstrated serum values below expected norms. These data suggest a relationship between coagulopathy and an intact functioning gastroin testinal tract. However, the relative importance of dietary versus end ogenous vitamin K produced by intestinal bacteria remains to be elucid ated.