What risk is heightened in children with burn injuries due to their larger body surface area compared to adults?

Children with burn injuries experience a heightened risk for dehydration and metabolic acidosis primarily due to their larger body surface area relative to their volume. When a child's skin is burned, the loss of integrity in the skin barrier allows for significant fluid loss through evaporation, leading to dehydration. This is compounded by the fact that children have a higher percentage of body water compared to adults, making them more susceptible to the effects of fluid losses.

Additionally, burns can lead to a systemic inflammatory response, which increases metabolic demands. In children, this can result in an increased metabolic rate, further exacerbating the risk of metabolic acidosis as the body may not be able to compensate for the hypermetabolic state with adequate fluid or electrolyte balance.

In contrast, although increased risk for infection is a consideration in burn injuries due to compromised skin integrity, the immediate physiological concerns stemming from dehydration and metabolic acidosis are more critical and pronounced in the pediatric population. This distinction highlights the importance of prompt and effective management of burn injuries in children to mitigate these risks.