Fever in burned children.

The patterns of rectal temperature (Tr) and skin surface temperatures (Tthigh and Ttoe) of 40 children were studied during the first 48 h after burn injury. The patients' ages ranged from 5 months to 12 years and all required intravenous resuscitation. On admission Tr measured 2-6h after the burn, ranged from 36.5 to 39.0 degrees C and 19 children had temperatures greater than 37.5 degrees C; the upper limit of the normal range for healthy children. Patients 5-12 months old had the lowest Tr during the early period. During the first 12 h Tr rose rapidly and 27 patients (67 per cent) had a fever (Tr greater than 38.5 degrees C). In 10 children Tr was greater than 40.0 degrees C. There was no relationship between the rise in Tr and the sex of the patient, the ambient temperature, the size, site or type of burn. Age was the most important variable, particularly during the first 12 h, where a positive correlation between Tr and age occurred in patients aged 5-23 months (P less than 0.01, r = 0.53). Throughout the first 48 h Tr remained elevated. Tthigh closely followed the pattern of Tr, but Ttoe varied considerably, reflecting cardiovascular as well as thermoregulatory responses.