The logical approach to understanding the complex metabolic derangements produced by a burn, is to link the disorder with a nutritional treatment. Since the goals of nutrition are directly linked with the metabolic changes, two complex topics become more simplified when linked together.

The best way to understand this extremely important topic is to break the metabolic problem and the nutritional support into its fundamental concepts then build on the basics.

There are two basic metabolic abnormalities produced by any burn. First there is a marked and persistent increase in energy demands by the burn patient initiated by the burn injury and the body’s ‘response’ to the injury. This constant high energy demand is comparable to jogging on a treadmill continuously for weeks to months, the pace increasing with burn size and other stressors.

The nutritional goal is to define the energy needs, then delivery the appropriate quantity and mix of nutrients to meet the energy demands.

The second abnormality is a destructive body catabolism which means a rapid and persistent breakdown of body protein. Since protein makes up the metabolic machinery and body structure, most prominently muscle, loss of protein is deleterious.

The nutritional goal is to provide the required protein intake, and stimulus for protein synthesis, in order to meet the increased demands for tissue synthesis and repair.