findings, but also have demonstrated that TPN fails to prevent hypercatabolism after thermal injury, and also worsens the stress response, increases endotoxin translocation, and further impairs mucosal immunity [79]. Standard of care in burns management thus mandates early enteral feeding whenever possible, to provide adequate nutrition in the setting of hypercatabolism, and to preserve the mucosal integrity and immune function of the gut.

Conclusion

Severe burn injury threatens every system in the body. Prevention of multiorgan failure necessitates preservation of tissue perfusion, as well as exacting implementation of critical care techniques. From the moment of injury, through the resuscitative period, and continuing through the recovery phase, care for burned patients requires attention to and support of organ function to prevent morbidity and mortality.

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Correspondence: Rob Sheridan, Shriners Hospital for Children, 51 Blossom Street, Boston, MA, 02114, USA, Phone: +16177265633, Fax: +16173678936, E-mail: rsheridan@part ners.org