Burn Cachexia: Diagnosis and Nutrition Support

Abstract

ABSTRACT

Abstract

Burn cachexia is a condition in which patients with major burns, especially patients with >20% total burn surface, present with significant rapid weight loss, muscle loss, and fat loss. Burn cachexia is also known as wasting syndrome and is characterized by severe weight loss, muscle and fat loss, fatigue, and anorexia. The current definition of burn cachexia includes association of an underlying disease condition characterized with muscle loss and with or without reduction in fat mass. Cachexia is driven by the molecular pathway known as the ubiquitin-proteolytic pathway. Cytokine activity plays a crucial role in the pathogenesis of cachexia; the consequent inflammation is the main cause of cachexia in major burns, and inflammatory cytokines are upregulated by reactive oxygen species that are triggered by nuclear transcription factor NF-κB. Some other well-known pathways are mitochondrial dysfunction and autophagy, endoplasmic reticulum stress, and insulin resistance. Burn cachexia is inflammation that induces protein degradation and increases cell death. Identification of burn-induced cachexia is a difficult challenge and, if untreated, can lead to death. Nutrition support is an extremely important part of burn management with cachexia and requires special attention. In this case report, we share the practical aspects of burn cachexia diagnosis and application of nutrition to prevent mortality. Our case involved a young male patient with electric burn injury who was diagnosed with burn-induced cachexia who had a successful outcome.