ABSTRACT
Bum injury provides a prototypical example of the ebb and flow phases of the metabolic response to injury described by Cuthbertson (1). Hemodynamic and metabolic depression (the ebb phase) occurs immediately after the bum. Among properly resuscitated patients with moderate-sized and larger surface area bums, the subsequent flow phase is characterized by supraphysiological levels of cardiac output and oxygen consumption. Augmentation of the metabolic rate may be as much as 100% (see Table 2). The hypermetabolism of bum injury is greater than that seen with any other form of trauma.
