Support of the metabolic response to burn injury

David Herndon, Ronald G. Tompkins

Research output: Contribution to journalArticle

306 Citations (Scopus)

Abstract

Severe burn causes metabolic disturbances that can last for a year after injury; persistent and profound catabolism hampers rehabilitative efforts and delays the meaningful return of individuals to society. The simplest, effective anabolic strategies for severe burn injuries are: early excision and grafting of the wound; prompt treatment of sepsis; maintenance of environmental temperature at 30-32°C; continuous feeding of a high carbohydrate, high protein diet, preferably by the enteral route; and early institution of vigorous and aerobic resistive exercise programmes. To further keep erosion of lean body mass to a minimum, administration of anabolic agents, recombinant human growth hormone, insulin, oxandrolone, or anticatabolic drugs such as propranolol are alternative approaches. Exogenous continuous low-dose insulin infusion, β blockade with propranolol, and use of the synthetic testosterone analogue oxandrolone are the most cost effective and least toxic pharmacological treatments to date.

Original languageEnglish (US)
Pages (from-to)1895-1902
Number of pages8
JournalLancet
Volume363
Issue number9424
DOIs
StatePublished - Jun 5 2004

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Oxandrolone
Propranolol
Wounds and Injuries
Insulin
Anabolic Agents
Human Growth Hormone
Poisons
Growth Hormone
Small Intestine
Testosterone
Sepsis
Maintenance
Carbohydrates
Pharmacology
Exercise
Diet
Costs and Cost Analysis
Temperature
Pharmaceutical Preparations
Proteins

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Support of the metabolic response to burn injury. / Herndon, David; Tompkins, Ronald G.

In: Lancet, Vol. 363, No. 9424, 05.06.2004, p. 1895-1902.

Research output: Contribution to journalArticle

Herndon, D & Tompkins, RG 2004, 'Support of the metabolic response to burn injury', Lancet, vol. 363, no. 9424, pp. 1895-1902. https://doi.org/10.1016/S0140-6736(04)16360-5
Herndon, David ; Tompkins, Ronald G. / Support of the metabolic response to burn injury. In: Lancet. 2004 ; Vol. 363, No. 9424. pp. 1895-1902.
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