Metabolism and nutrition in burned patients.

The hypermetabolic and protein-wasting syndrome of burn injury is quantitatively the most severe and prolonged encountered in acute surgical diseases. It demands nutritional care to minimize the multiple complications of malnutrition. Nutritional support today is aimed at a daily administration of calories between 1.37 and 1.7 times the basal metabolic rate with 20% or more of these calories as protein. Fat emulsions are used twice weekly to replace essential fatty acids. Vitamins, minerals, and trace metals are supplied regularly. Current recommendations can be made based on a decade of experience, but they are changing rapidly with increased knowledge of the metabolic abnormalities occurring in the burn patients and on experience with a decade of nutritional replacement.