Metabolic and Nutritional Support

Shahriar Shahrokhi; Marc G Jeschke

doi:10.1016/j.suc.2023.01.009

Metabolic and Nutritional Support

Surg Clin North Am. 2023 Jun;103(3):473-482. doi: 10.1016/j.suc.2023.01.009. Epub 2023 Mar 21.

Authors

Shahriar Shahrokhi¹, Marc G Jeschke²

Affiliations

¹ Burn Program at Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
² Burn Program at Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada; TaAri Institute, Hamilton Health Sciences Research Institute, Hamilton, Ontario, Canada; David Braley Research Institute, C5-104, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada. Electronic address: marc.jeschke@hhsc.ca.

PMID: 37149383
DOI: 10.1016/j.suc.2023.01.009

Abstract

Hypermetabolism is a hallmark of larger burn injuries. The hypermetabolic response is characterized by marked and sustained increases in catecholamines, glucocorticoids, and glucagon. There is an increasing body of literature for nutrition and metabolic treatment and supplementation to counter the hypermetabolic and catabolic response secondary to burn injury. Early and adequate nutrition is key in addition to adjunctive therapies, such as oxandrolone, insulin, metformin, and propranolol. The duration of administration of anabolic agents should be at minimum for the duration of hospitalization, and possibly up to 2 to 3 years postburn.

Keywords: Glucose; Lipid; Metabolism; Nutrition; Proteins.

Publication types

Review

MeSH terms

Anabolic Agents*
Burns* / therapy
Humans
Insulin
Nutritional Support
Oxandrolone

Substances

Anabolic Agents
Oxandrolone
Insulin