Which metabolic alteration is noted during the ebb response following burn injury in a pediatric patient?

• A. Elevated catecholamines
• B. Decreased resting energy expenditure
• C. Elevated plasma insulin
• D. Anabolism

Answer: (B)

The main idea here is the ebb phase after a burn, when the body shifts into a short, stabilization-focused metabolic pattern. In this early period, especially in children, resting energy expenditure actually drops. The body reduces overall metabolic activity as perfusion and cardiac output are still recovering, and heat production decreases, so energy use is lowered rather than increased. This hypo-metabolic state is temporary; as time passes, the body usually enters a hypermetabolic flow phase with higher energy needs and catabolism driven by stress hormones.

Why this is the best choice: the defining change during the ebb is a decrease in resting energy expenditure, reflecting the body’s need to conserve energy for resuscitation and stabilization rather than to drive growth or repair. Elevated catecholamines can occur as part of the stress response but do not define the ebb’s metabolic pattern. Elevated insulin would be unlikely in this phase, and anabolism is not characteristic of the ebb, which is a catabolic, not a constructive, period.