Journal
CLINICS IN PLASTIC SURGERY
Volume 44, Issue 3, Pages 541-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.cps.2017.02.013
Keywords
Hypermetabolism; Hypercatabolism; Insulin resistance; Propranolol; Oxandrolone; Nutrition; Catecholamines
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Severe burn injury is followed by a profound hypermetabolic response that persists up to 2 years after injury. It is mediated by up to 50-fold elevations in plasma catecholamines, cortisol, and glucagon that lead to whole-body catabolism, elevated resting energy expenditures, and multiorgan dysfunction. Modulation of the response by early excision and grafting of burn wounds, thermoregulation, control of infection, early and continuous enteral nutrition, and pharmacologic treatments aimed at mitigating physiologic derangements have markedly decreased morbidity.
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