Post burn muscle wasting and the effects of treatments

Clifford Pereira, Kevin Murphy, Marc Jeschke, David Herndon

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Severe burns are typically followed by a hypermetabolic response that lasts for at least 9-12 months post-injury. The endocrine status is also markedly altered with an initial and then sustained increase in proinflammatory 'stress' hormones such as cortisol and other glucocorticoids, and catecholamines including epinephrine and norepinephrine by the adrenal medulla and cortex. These hormones exert catabolic effects leading to muscle wasting, the intensity of which depends upon the percentage of total body surface area (TBSA) involved, as well as the time elapsed since initial injury. Pharmacological and non-pharmacological strategies may be used to reverse the catabolic effect of thermal injury. Non-pharmacological strategies include early excision and wound closure of burn wound, aggressive treatment of sepsis, elevation of the environmental temperature to thermal neutrality (31.5 ± 0.7°C), high carbohydrate, high protein continuous enteral feeding and early institution of resistive exercise programs. Pharmacological modulators of the post-burn hypermetabolic response may be achieved through the administration of recombinant human growth hormone, low dose insulin infusion, use of the synthetic testosterone analogue, oxandrolone and beta blockade with propranolol. This paper aims to review the current understanding of post-burn muscle proteolysis and the effects of clinical and pharmacological strategies currently being studied to reverse it curb these debilitating sequelae of severe burns.

Original languageEnglish (US)
Pages (from-to)1948-1961
Number of pages14
JournalInternational Journal of Biochemistry and Cell Biology
Volume37
Issue number10 SPEC. ISS.
DOIs
StatePublished - Oct 2005

Fingerprint

Muscle
Oxandrolone
Burns
Hormones
Proteolysis
Curbs
Muscles
Human Growth Hormone
Wounds and Injuries
Propranolol
Modulators
Glucocorticoids
Epinephrine
Catecholamines
Hydrocortisone
Testosterone
Pharmacology
Norepinephrine
Carbohydrates
Insulin

Keywords

  • Anabolic
  • Burns
  • Hypermetabolism
  • Muscle
  • Wasting

ASJC Scopus subject areas

  • Biochemistry
  • Cell Biology

Cite this

Post burn muscle wasting and the effects of treatments. / Pereira, Clifford; Murphy, Kevin; Jeschke, Marc; Herndon, David.

In: International Journal of Biochemistry and Cell Biology, Vol. 37, No. 10 SPEC. ISS., 10.2005, p. 1948-1961.

Research output: Contribution to journalArticle

Pereira, C, Murphy, K, Jeschke, M & Herndon, D 2005, 'Post burn muscle wasting and the effects of treatments', International Journal of Biochemistry and Cell Biology, vol. 37, no. 10 SPEC. ISS., pp. 1948-1961. https://doi.org/10.1016/j.biocel.2005.05.009
Pereira, Clifford ; Murphy, Kevin ; Jeschke, Marc ; Herndon, David. / Post burn muscle wasting and the effects of treatments. In: International Journal of Biochemistry and Cell Biology. 2005 ; Vol. 37, No. 10 SPEC. ISS. pp. 1948-1961.
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