Iron metabolism in burned children

The administration of iron supplementation in children with burns has been a subject of controversy. Recent studies argue against its use in the acute phase of stress. To assess whether iron metabolism parameters show signifi cant differences in the acute phase and the recovery phase of burn, 21 pati ents (age range: 17 months to 13 years) with bunts of more than 10% of body surface who had not received blood transfusions or iron supplementation we re studied. Sideraemia, ferritin, transferrin, transferrin saturation index (TSI) and C-reactive protein (CRP) were assessed both in the acute and the recovery phase after burn. Sideraemia, transferrin, and TSI were significa ntly lower in the acute than in the recovery phase (17.3 +/- 3 vs 53.8 +/- 6.6 mu g/dL, 190.5 +/- 15 vs 287.9 +/- 14.3 mg/dL and 7.7 +/- 1.3 vs 15.4 /- 1.6%, P < 0.0001, P < 0.001 and P = 0.0006, respectively) while plasma f erritin and CRP were significantly higher (84.7 +/- 8.8 vs 43.1 +/- 8.5 ng/ mL and 9.5 +/- 1.5 vs 0.7 +/- 0.2 mg/dL, P = 0.016 and P < 0.0001, respecti vely). When the above parameters were analysed based on age (less than or e qual to 2 years, >2 years), the observed differences persisted, Conclusion Hyposideraemia is a frequent finding in the acute phase of paedi atric burns and is accompanied by increased ferritin levels and decreased t ransferrin concentrations. The low iron values and to recover without the u se of iron supplementation suggesting an endogenous block or iron release i n the acute phase and indicates that iron therapy should be not recommended in the initial period of stress of the burned patient.