Which of the following is NOT a characteristic of the flow response after burns?

• A. Elevated catecholamines
• B. Hyperglycemia
• C. Decreased body temperature
• D. Increased urinary excretion of nitrogen, sulphur, magnesium, phosphorus and potassium

Answer: (C)

After a burn, the body’s metabolic response unfolds in two phases, with the flow phase representing a sustained hypermetabolic state driven by elevated stress hormones and inflammatory signals. In this phase, catecholamines rise, fueling a high energy demand and contributing to insulin resistance that leads to hyperglycemia. Proteolysis and gluconeogenesis increase, producing a negative nitrogen balance, and there are marked losses of minerals and nitrogen in the urine as tissues are broken down.

The statement that does not fit the flow response is decreased body temperature. In the flow phase, temperature tends to be normal or elevated due to the systemic inflammatory response and ongoing heat production; hypothermia is more typical of the initial ebb phase right after injury, when perfusion is compromised and heat loss is greater. The other features—elevated catecholamines, hyperglycemia, and increased urinary excretion of nitrogen and minerals—are characteristic of the flow response.