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

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

Answer: (A)

In burn injuries, metabolism shifts from an initial ebb period to a later hypermetabolic flow. The ebb phase is a brief, early period of reduced metabolic activity aimed at conserving energy during resuscitation, so resting energy expenditure decreases below baseline. This contrasts with the later phase, when catecholamines rise and energy expenditure increases, driving hypermetabolism and catabolism. Anabolism or elevated insulin levels are not hallmarks of the ebb period, which is characterized by a lower metabolic rate rather than a building, energy-storing state.