How do burns impact metabolism?

• A. A hypercatabolic state with increased energy expenditure
• B. A hypometabolic state with decreased energy expenditure
• C. No change in energy expenditure
• D. Increased protein catabolism only

Answer: (A)

Burn injuries trigger a systemic inflammatory response that drives a hypermetabolic, hypercatabolic state. The body’s resting energy expenditure rises significantly, sometimes by a large percentage depending on burn size and duration. At the same time, there is accelerated breakdown of both fat and lean tissue (proteolysis and lipolysis) to supply amino acids and energy for wound healing and immune function. This creates a negative nitrogen balance and substantial muscle wasting if nutrition isn’t increased accordingly. So the overall metabolic shift is an increased energy demand with increased tissue catabolism, not a lowered or unchanged metabolism or a change limited only to protein breakdown.