Reduced immunity at a cellular and humoral level results in increased infections and decreased healing.This results in a series of complications and morbidities Lactate increase: anaerobic metabolism resulting in carbohydrate cycling (less energy than aerobic metabolism) with reduced nitiogren balance.Glucose increase: Increased glycogenolysis causes hyperglycemia (excess glucose is metabolised anaerobically resulting in lactate production) to create a diabetic-like state.Hormone shift: increased stress hormones cortisol, catecholamine and reduced anabolic hormones (growth hormone, insulin and anabolic steroids).Hyperthermia: core temperature can be chronically elevated.Hyperdynamic circulation: increased cardiac output, increased oxygen consumption and C02 production.PhysiologyĪt a physiological level, the hypermetabolic response occurs due to: This response does not return to "normal" until wound remodelling is complete.Ĭlinically, these patients have tachycardia, hyperthermia & protein wasting. The ebb is a hypodynamic period that occurs ~48 hours after a burn, which is then followed by a hypermetabolic flow phase. The response to a burn can be described as an "ebb and flow". Examples of inflammatory mediators are free oxygen radicals and histamine.įollowing a hypodynamic period, a hypermetabolic response occurs at a cellular and humoral level resulting in changes to metabolism, hormones, cardiorespiratory function, gastrointestinal function, and immunity.After this initial response, this zone should return to normal.Results in the fluid shift into the interstitial space.Inflammatory mediators result in vasodilation and increased permeability.The outermost zone surrounding the region of compromised vasculature.The extent of progress is influenced by the effectiveness of resuscitation. ![]()
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