Table 5.
Summary of reported abundances for biomarkers involved in the hypothalamic pituitary adrenal axis in children with burns
| Reference | Source | Reported normal limits | Abundance in burns | Age range | Time frame | Population TBSA (%) |
|---|---|---|---|---|---|---|
| AVP | ||||||
| Palmieri et al. (2006) [115] | Blood | <2 pg/mL | Within normal limits 2.2 ± 0.9 pg/mL | 0–17 years | Admission to 8 weeks post-burn | 41.8 ± 3.8a |
| Sedowofia et al. (1998) [22] | Blood | Not reported | Elevated 7.1–18.3 pmol/L | 5 months-13 years | Admission to 18 hours, post-admission | 20.5 ± 2.7a |
| ACTH | ||||||
| Palmieri et al. (2006) [115] | Blood | 3–50 ng/dL | Within normal limits 15.1 ± 6.9 ng/dL | 0–17 years | Admission to 8 weeks post-burn | 41.8 ± 3.8a |
| Cortisol | ||||||
| Palmieri et al. (2006) [115] | Blood | 5–20 μg/dl | Within normal limits 14.1 ± 4.6 μg/dl | 0–17 years | 2 months post-burn | 41.8 ± 3.8a |
| Sedowofia et al. (1998) [22] | Blood | Not reported | Elevated 221.6–650.6 nmol/L | 5 months-13 years | For up to 24 hours post-burn | 20.5 ± 2.7a |
| Fleming et al. (1992) [95] | Blood | 7–27 milligram/dL | Within normal limits 21.3 ± 1.6 milligram/dL | Mean age of 11.1 years | At mean of 12.6 days post-burn | 67 ± 6a |
| Gottschlich et al. (2002) [103] | Blood | 4–28 μg/dL | Elevated 24.1 ± 2 μg/mL | Children >3 years | Up to 4 weeks post-burn | 53.2 ± 3.4a |
| Jeschke et al. (2008a) [37] | Blood | 17.5 ng/mL† | Elevated 20–24.5 ng/mL† | 8.0 ± 0.2 years | Up to 22 days post-burn | 56 ± 0.3a |
| Jeschke et al. (2011) [38] | Blood | 10 g/dL† | Elevated 20–43 g/dL† | 7.5 ± 5.3 years | Up to 1100 days post-burn | 50 ± 20b |
| Jeschke et al. (2008a) [37] | Urine | 90 ng/mL† | Elevated 170–350 ng/mL† | 8.0 ± 0.2 years | Up to 60 days post-burn | 56 ± 0.3a |
| Jeschke et al. (2012a) [45] | Urine (in 24 hours) | 5–21 μg/24 hours | Elevated 163 ± 56 μg/24 hours | 0–18 years | Until 250 days post-burn | 64 ± 12b |
| Jeschke et al. (2008b) [48] | Urine (in 24 hours) | Not reported | Elevated 185–430 μg/day† | 0–18 years | Immediately after burn | >40c |
| Klein et al. (1995) [41] | Urine (in 24 hours) | 8–47 mg/24 hours | Elevated 395 ± 284 mg/24 hours | 5.8–17.5 years | 3 weeks post-burn | 63 ± 16a |
| Gauglitz et al. (2009) [43] | Urine (in 24 hours) | 38 μg/day† | Elevated 139 ± 11 μg/24 hours | 0–18 years | 3 years post-burn | 57.9 ± 14.7b |
| Jeschke et al. (2012b) [134] | Urine (in 24 hours) | Not reported | Elevated 80–300 μg/day† | Mean age 9 years | 60 days post-burn | 64 ± 12a |
| Norbury et al. (2008) [23] | Urine (in 24 hours) | 10–70 μg/24 hours† | Elevated 145–284 μg/day† | 9.5 ± 5.1 (males) 6.7 ± 4.8 (females) | Up to 100 days post-burn | 58.7 ± 16.9 (males)a 56.8 ± 14.9 (females)a |
| Jeschke et al. (2011) [38] | Urine | 25 μg/day† | Elevated 75–175 μg/day† | 7.5 ± 5.3 years | Up to 1100 days post-burn | 50 ± 20b |
| Klein et al. (2004) | Urine | Maximum 50 μg/day | Elevated 371 ± 147 μg/day | 7–18 years | Not recorded | >40c |
| DHEA-S | ||||||
| Palmieri et al. (2006) [115] | Blood | 10–140 μg/dL | Within normal limits 102.8 + _32.3 μg/dL | 0–17 years | From admission to 8 weeks post-burn | 41.8 ± 3.8a |
†Data derived from graph, aData presented as mean ± SEM, bData presented as mean ± SD, cData presented as minimum value
TBSA total body surface area, AVP arginine vasopressin, DHEA-S dehydroepiandrosterone sulphate