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Modulation of the Post-Burn Hypermetabolic State

机译：调制后烧伤过高代谢状态

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Burn patients have the highest metabolic rate of all critically ill or injured patients. The metabolic response to a severe burn injury is characterized by a hyperdynamic cardiovascular response, increased energy expenditure, accelerated glycogen and protein breakdown, lipolysis, loss of lean body mass and body weight, delayed wound healing, and immune depression [1, 2). This response is mediated by increases in circulating levels of the catabolic hormones, catecholamines, cortisol, and glucagon [3]. Catecholamin.es increase up to 10 times normal. Catabolism after major burn injury begins on the 5th day after injury and continues up to 9 months later [4]. Increasing age, weight, and delay in definitive surgical treatment predict increased catabolism in children. In adults, the response increases up to age 50 where it plateaus [5]. The body surface area burned increases catabolism until a 40% body burn is reached. The magnitude of metabolic expenditure is 1.5 to twice normal in burns of greater than 40% totalbody surface area (TBSA). Catabolism is further increased by 50% with environmental cooling or the development of sepsis.
机译：烧伤患者的代谢率最高的患者的最高代谢率。对严重燃烧损伤的代谢反应是通过高动态心血管反应，增加能量消耗，加速糖原和蛋白质分解，脂解，瘦体重丧失，体重，延迟伤口愈合和免疫凹陷[1,2）。该响应是通过循环水分解素，儿茶酚胺，皮质醇和胰高血糖素的循环水平的增加介导的介导的[3]。儿茶素素人数最多增加10倍。重症烧伤后的分解代谢在伤害后的第5天开始，并持续到9个月后[4]。年龄增加，重量和延迟明确的外科治疗预测儿童的分解代谢增加。在成年人中，响应增加到50岁以下，其中Plateaus [5]。烧焦的体表面积增加分解代谢直至达到40％的体烧伤。在大于40％的总体表面积（TBSA）的烧伤中，代谢支出的大小是正常的1.5至正常。随着环境冷却或败血症的发育，分解代谢进一步增加了50％。

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