Modulation of the Hypermetabolic Response after Burn Injury

The hypermetabolic response to severe burn injury can profoundly delay recovery and rehabilitation after the injury. Increased cardiac work, elevated resting energy expenditure, and loss of lean body mass with subsequent decreased muscle strength result from post-burn hypermetabolism. Additionally, elements of the hypermetabolic response remain elevated above normal for up to 3 years. This chapter reviews the metabolic alterations that occur after severe burn injury as well as various pharmacological therapies that are being used and/or investigated for use to attenuate the hypermetabolic response.