The Pathophysiology of Severe Thermal Injury

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Abstract
Major thermal injuries are always accompanied by marked patho-physiologic and immunologic changes. This article offers a broad perspective on the current understanding of such changes. Specifically addressed are (1) the pathophysiology of the burn wound (including the contributions of the inflammatory response, resuscitation fluid and suppression of increased micro-vascular permeability, effects of selected drugs and modulators of the arachidonic acid cascade); (2) wound infection and impaired host defense to infection (including the contributions of the inflammatory system and the specific immune response); and (3) hypermetabolism and increased energy demand (including hormonal alterations, liver and muscle metabolism, edema, and nutritional considerations). An extensive bibliography of recent research in these areas is also offered as a reference for continued investigation.

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