Skeletal muscle wasting after a severe burn is a consequence of cachexia and sarcopenia

Juquan Song, Audra Clark, Charles E. Wade, Steven E. Wolf

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Muscle wasting is common and persistent in severely burned patients, worsened by immobilization during treatment. In this review, we posit two major phenotypes of muscle wasting after severe burn, cachexia and sarcopenia, each with distinguishing characteristics to result in muscle atrophy; these characteristics are also likely present in other critically ill populations. An online search was conducted from the PubMed database and other available online resources and we manually extracted published articles in a systematic mini review. We describe the current definitions and characteristics of cachexia and sarcopenia and relate these to muscle wasting after severe burn. We then discuss these putative mechanisms of muscle atrophy in this condition. Severe burn and immobilization have distinctive patterns in mediating muscle wasting and muscle atrophy. In considering these two pathological phenotypes (cachexia and sarcopenia), we propose two independent principal causes and mechanisms of muscle mass loss after burns: (1) inflammation-induced cachexia, leading to proteolysis and protein degradation, and (2) sarcopenia/immobility that signals inhibition of expected increases in protein synthesis in response to protein loss. Because both are present following severe burn, these should be considered independently in devising treatments. Discussing cachexia and sarcopenia as independent mechanisms of severe burn–initiated muscle wasting is explored. Recognition of these associated mechanisms will likely improve outcomes.

Original languageEnglish (US)
Pages (from-to)1627-1633
Number of pages7
JournalJournal of Parenteral and Enteral Nutrition
Issue number8
StatePublished - Nov 2021


  • cachexia
  • immobilization
  • muscle atrophy
  • sarcopenia
  • thermal injury

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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