Burn Program at Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Burn Program at Hamilton Health Sciences, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada; TaAri Institute, Hamilton Health Sciences Research Institute, Hamilton, Ontario, Canada; David Braley Research Institute, C5-104, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
Surg Clin North Am. 2023 Jun;103(3):473-482. doi: 10.1016/j.suc.2023.01.009. Epub 2023 Mar 21.
Hypermetabolism is a hallmark of larger burn injuries. The hypermetabolic response is characterized by marked and sustained increases in catecholamines, glucocorticoids, and glucagon. There is an increasing body of literature for nutrition and metabolic treatment and supplementation to counter the hypermetabolic and catabolic response secondary to burn injury. Early and adequate nutrition is key in addition to adjunctive therapies, such as oxandrolone, insulin, metformin, and propranolol. The duration of administration of anabolic agents should be at minimum for the duration of hospitalization, and possibly up to 2 to 3 years postburn.
高代谢是大面积烧伤的一个标志。高代谢反应的特征是儿茶酚胺、糖皮质激素和胰高血糖素显著和持续增加。越来越多的文献报道了营养和代谢治疗以及补充剂,以对抗烧伤后继发的高代谢和分解代谢反应。早期和充足的营养是关键,除此之外还有辅助治疗,如氧雄龙、胰岛素、二甲双胍和普萘洛尔。合成代谢药物的给药时间应至少持续到住院期间,并可能持续到烧伤后 2 至 3 年。