The metabolic problems of the burn patient

Metabolic problems of the extensively burned patient, which occur as a result of the injury and its sequelae as well as the treatment employed, present at characteristic times postburn. The frequency, severity, and duration of metabolic complications are proportional to burn size and involve virtually every organ system. In the immediate postburn period, prompt and adequate resuscitation will prevent or correct metabolic disturbances and following resuscitation careful fluid and ventilatory management reduce the occurrence of metabolic problems. The physiologic changes, which characterize postburn hypermetabolism per se and the pathophysiologic effects of sepsis, are described and used to define metabolic needs and the nutritional and other supportive measures necessary to maintain body mass and function, promote wound healing, and reduce morbidity and mortality.