Every year, patients with burn injuries account for approximately 500,000 hospital emergency department visits in the United States. While most burn injuries are minor, 40,000 hospitalizations related to severe burn injuries occur annually. Severe burn injuries result in metabolic inflammatory alterations that are similar to those presented by other major trauma patients. However the severity, length, and magnitude of these changes are most profound and prolonged in patients with burn injuries. In fact, insulin resistant, hyperglycemic, hypermetabolic state of burn injury patients was found to persist for up to three years. The complex condition of hypermetabolism plays a critical role in the healing and long-term outcomes to severe burn injury in a patient.
There are 2 distinct phases in the post-burn hypermetabolic response that correspond to the phases of the severe injury induced stress response that was first described by Cuthbertson. These phases of the hypermetabolic response are thought to be initiated by the rise in the levels of catecholamines, corticosteroids, and inflammatory cytokines that occurs following burn injury.