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[Evaluation of the balance between energy supplement and consumption in patients with serious burn: a problem worth further investigation].

The energy expenditure of burn patients can be determined accurately by indirect calorimetry measurement, or estimated approximately with energy expenditure equations. However, the energy requirement is not entirely equal to energy expenditure in the whole process of burn injury. The energy consumption induced by hyper catabolism is increased significantly, and on the other hand, the ability of nutrient absorption and anabolism decreased remarkably in the early phase of burn injury, thus leading to imbalance between energy consumption and demand. However, energy supplement as calculated according to energy consumption may induce overfeeding in the early phase of burn injury. Excessive nutrients intake can not be fully utilized to decrease hypermetabolic reaction, but it might exacerbate metabolic disorder. Therefore, the energy supplement should be lower than energy consumption during the early stage of burns. With the advance of disease course, the internal environment becomes stable gradually, ending in a balance between anabolism and catabolism. Energy supplement should be increased gradually according to energy consumption. During the convalescent period, anabolic metabolism exceeds catabolic metabolism, therefore the quantity of energy supplement should be moderately higher than that of energy consumption. Thus, the energy consumption and energy supplement may reach a balance during the whole course of treatment. The purpose of the article is to analyze and discuss how to estimate energy expenditure precisely and evaluate energy requirement correctly, in order to reach a balance between energy consumption and supplement during a long course of treatment for severe burn patients.