Pathophysiology and Hypermetabolic Response to Burn

Burns account for an estimated 300,000 deaths per year worldwide, with a dearth of patients necessitating medical attention—ranking fourth in incidence compared to all injury types. What distinguishes burns from other forms of trauma is the persistent, severe metabolic and inflammatory response after the initial insult, which has a critical impact on patient outcomes. In particular, the post-burn hypermetabolic response is a key contributor to burn-related complications, necessitating a better understanding of this response beyond identification of its components. In this chapter, we define the hypermetabolic response and aim to discuss the key sequelae, focusing first on metabolic then organ-specific consequences. We conclude with a discussion on current management of hypermetabolism, including conservative and pharmacological intervention. Early identification and management of hypermetabolic consequences can improve outcomes in burn patients.