Dr. Shilpi Baranwal


Burns is capable of causing significant metabolic derangements due to which nutritional support becomes extremely pivotal for burns patients.
Burns Injury causes persistent & prolonged hypermetabolic state with increased catabolism that leads to excessive muscle wasting and cachexia.
Basal Metabolic rate in burns patients can become manifolds so that often with standard nutritional support, the massive energy demands are not
met with leading to increased susceptibility to infection, systemic derangements, organ dysfunction and impaired wound healing.
Though early enteral nutrition with increased energy intake formulae have been preferred whenever applicable in burns patients, the optimal
timing, route, amount, quantity and composition of nutritional formulae for burns patients is always debatable.
Therefore, it should be individualised, monitored and adjusted throughout the course of treatment and needs to be modified at various phases of


Hypermetabolism, cachexia, parenteral, sepsis, calorimetry, respiratory quotient,overfeeding

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Metabolic changes in burn patients. Wilmore DW,Aulick LH.Surg Clin North Am 1978;58(6):1173-87

DP,Angeles Valero Zanuy MA,Leon Sanz ML.Post shock metabolic response. Cuthbertson DP,Angeles Valero Zanuy MA,Leon Sanz ML.Nutr Hosp 2001;16(5):176-82

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Effect of severe burn injury on substrate cycling by glucose and fatty acids.Wolfe RR, Herndon DN, Jahoor F, Miyoshi H, Wolfe M N Engl J Med. 1987 Aug 13; 317(7):403-8.


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