Support of the metabolic response to burn injury

David N. Herndon, Ronald G. Tompkins

Research output: Contribution to journalReview article

331 Scopus citations

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
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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    Herndon, D. N., & Tompkins, R. G. (2004). Support of the metabolic response to burn injury. Lancet, 363(9424), 1895-1902. https://doi.org/10.1016/S0140-6736(04)16360-5