Hypermetabolic Response to Burn Injury

The stress response to injuries like burns and sepsis entails a number of endocrine, metabolic, and immunological changes. These alterations in the secretion of key hormones and cytokines in the initial stages of the injury are believed to be a necessary and beneficial response. However, an exaggerated and prolonged stress response results in the dysfunction and breakdown of key metabolic tissues of the body. The adverse effects of the stress response also goes beyond the tissue level and has been implicated as a negative predictor of poor outcome, infections, and longer hospital stays in patients. For these reasons, a comprehensive and physiological detail of the hypermetabolic response to injury is warranted to better understand how this pro-survival response transforms into catastrophic response. In addition, the scrutiny of this stress response will enhance our understanding of the different types of therapies available to attenuate this catabolic response. Thus, this chapter aims to review the pathophysiological mechanisms, the clinical consequences, and therapeutic implications of the hypermetabolic response to burn injury.