ABSTRACT
Introduction..............................................................................................................66 Calculating Caloric Needs....................................................................................... 67 Dietary Composition................................................................................................67 Dietary Delivery..................................................................................................... 68 Transitioning to Regular Diet................................................................................ 70 Summary................................................................................................................ 71
INTRODUCTION
The response to injury, known as hypermetabolism, occurs most dramatically following severe burn. Increases in oxygen consumption, metabolic rate, urinary nitrogen excretion, lipolysis and weight loss are directly proportional to the size of the burn.1 This response can be as high as 200% of the normal metabolic rate, and returns to normal only with the complete closure of the burn wound.2 There is debate regarding the pathogenesis of this hypermetabolic state, but the general consensus is that inflammation associated with the burn wound, heightened cortisolemia, and the increased adrenergic activity seen in these patients are all important factors.
