Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism, adrenergic stress and hypothalamic regulation—a systematic review

Viktoria Mertin; Patrick Most; Martin Busch; Stefan Trojan; Christian Tapking; Valentin Haug; Ulrich Kneser; Gabriel Hundeshagen

doi:10.1093/burnst/tkac031

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Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism, adrenergic stress and hypothalamic regulation—a systematic review

更新时间：2023-09-05

- Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism, adrenergic stress and hypothalamic regulation—a systematic review
- Burns & Trauma Vol. 10, Issue 1, (2022)
- 作者机构：
  
  1. University of Heidelberg
  2. Department of Internal Medicine III University Hospital Heidelberg
  3. Deutsches Zentrum für Herz- und Kreislaufforschung (GCCR)
  4. University of Witten/Herdecke
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkac031
  CLC：
- Published：2022，
  
  Published Online：23 September 2022，
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Viktoria Mertin, Patrick Most, Martin Busch, Stefan Trojan, Christian Tapking, Valentin Haug, Ulrich Kneser, Gabriel Hundeshagen, Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism, adrenergic stress and hypothalamic regulation—a systematic review, Burns & Trauma, Volume 10, 2022, tkac031, https://doi.org/10.1093/burnst/tkac031
DOI：

Viktoria Mertin, Patrick Most, Martin Busch, Stefan Trojan, Christian Tapking, Valentin Haug, Ulrich Kneser, Gabriel Hundeshagen, Current understanding of thermo(dys)regulation in severe burn injury and the pathophysiological influence of hypermetabolism, adrenergic stress and hypothalamic regulation—a systematic review, Burns & Trauma, Volume 10, 2022, tkac031, https://doi.org/10.1093/burnst/tkac031 DOI：

摘要

Abstract

BackgroundIn this systematic review

we summarize the aetiology as well as the current knowledge regarding thermo(dys)regulation and hypothermia after severe burn trauma and aim to present key concepts of pathophysiology and treatment options. Severe burn injuries with >20% total body surface area (TBSA) affected commonly leave the patient requiring several surgical procedures

prolonged hospital stays and cause substantial changes to body composition and metabolism in the acute and long-term phase. Particularly in severely burned patients

the loss of intact skin and the dysregulation of peripheral and central thermoregulatory processes may lead to substantial complications.MethodsA systematic and protocol-based search for suitable publications was conducted following the PRISMA guidelines. Articles were screened and included if deemed eligible. This encompasses animal-based in vivo studies as well as clinical studies examining the control-loops of thermoregulation and metabolic stability within burn patientsResultsBoth experimental animal studies and clinical studies examining thermoregulation and metabolic functions within burn patients have produced a general understanding of core concepts which are

nonetheless

lacking in detail. We describe the wide range of pathophysiological alterations observed after severe burn trauma and highlight the association between thermoregulation and hypermetabolism as well as the interactions between nearly all organ systems. Lastly

the current clinical standards of mitigating the negative effects of thermodysregulation and hypothermia are summarized

as a comprehensive understanding and implementation of the key concepts is critical for patient survival and long-term well-being.ConclusionsThe available in vivo animal models have provided many insights into the interwoven pathophysiology of severe burn injury

especially concerning thermoregulation. We offer an outlook on concepts of altered central thermoregulation from non-burn research as potential areas of future research interest and aim to provide an overview of the clinical implications of temperature management in burn patients.

关键词

Keywords

Animal modelBurn shockHypothermiaThermoregulationTemperature managementBurn injuryHypermetabolism

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