Nazihah Bakhtyar, Thibacg Sivayoganathan, and Marc G Jeschke
The complex pathophysiologic response of hypermetabolism plays a central role for the acute and long term outcomes in severely burned patients. Burns encompassing greater than 20% total body surface area (TBSA) are characterized by stress, insulin resistance, hyperglycemia, lipolysis and catabolism. The objective of this review is to discuss landmark studies in the field of hypermetabolism postburn with regards to the current best practice for efficacious burn care and to investigate the pros and cons of those treatments. Different modalities were identified from the literature to ameliorate the hypermetabolic condition. These include early excision and closure of the burn wounds, external thermoregulation, adequate nutritional supplementation, exercise and the utilization of various pharmacologic treatments. Furthermore, we included future avenues of research with regards to treating the complex condition of hypermetabolism and determining how we can create personalized treatments for the unique set of hypermetabolic conditions presented in each patient.