<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092021000400194</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hipermetabolismo en el paciente quemado]]></article-title>
<article-title xml:lang="en"><![CDATA[Hypermetabolism in the burned patient]]></article-title>
<article-title xml:lang="pt"><![CDATA[Hipermetabolismo nos pacientes queimados]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garnica Escamilla]]></surname>
<given-names><![CDATA[Marco Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lemus Sandoval]]></surname>
<given-names><![CDATA[Jordana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez Martínez]]></surname>
<given-names><![CDATA[Bricia Noemí]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tamez Coyotzin]]></surname>
<given-names><![CDATA[Elvira Alejandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marín Landa]]></surname>
<given-names><![CDATA[Oscar Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Rehabilitación, «Luis Guillermo Ibarra Ibarra» Centro Nacional de Investigación y Atención de Quemados ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General «Dr. Manuel Gea González» Unidad de Cuidados Intensivos ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<volume>35</volume>
<numero>4</numero>
<fpage>194</fpage>
<lpage>199</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092021000400194&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092021000400194&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092021000400194&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La lesión por quemadura se denomina con frecuencia la forma más grave de trauma en relación con la elevada respuesta metabólica que genera debido a que puede perpetuarse y permanecer elevada incluso hasta tres años después de que la lesión se ha resuelto. Las alteraciones en el metabolismo son complejas debido a los diversos mecanismos involucrados (hormonales, inflamatorios, metabólicos y genéticos). Existen también en la actualidad diversos mecanismos implementados con la finalidad de tratar de frenar esta respuesta hipermetabólica. La finalidad de este artículo es dar a conocer al personal médico cuáles son las principales causas del hipermetabolismo y las estrategias de manejo que existen en el tratamiento del quemado grave.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Burn injury is often referred to as the most severe form of trauma in relation to the high metabolic response it generates because it can be perpetuated and remain elevated even up three years after the injury has resolved. Metabolic alterations are complex due to various mechanisms involved (metabolic, hormonal, inflammatory and genetic). Currently there are several mechanisms implemented in order to try to stop this hypermetabolic response. The purpose of this article is to inform medical personnel, which are the main causes of hypermetabolism and management strategies that exist in the treatment of severe burn.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A lesão por queimadura é freqüentemente referida como a forma mais grave de trauma em relação à alta resposta metabólica que gera, pois pode perpetuarse e permanecer elevada até três anos após a resolução da lesão. As alterações do metabolismo são complexas devido aos vários mecanismos envolvidos (hormonais, inflamatórios, metabólicos e genéticos). Existem também atualmente vários mecanismos implementados a fim de tentar parar esta resposta hipermetabólica. O objetivo deste artigo é dar a conhecer à equipe médica, quais são as principais causas do hipermetabolismo e as estratégias de manejo que existem no tratamento de queimaduras graves.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hipermetabolismo]]></kwd>
<kwd lng="es"><![CDATA[nutrición]]></kwd>
<kwd lng="es"><![CDATA[paciente quemado]]></kwd>
<kwd lng="en"><![CDATA[Hypermetabolism]]></kwd>
<kwd lng="en"><![CDATA[nutrition]]></kwd>
<kwd lng="en"><![CDATA[burned patient]]></kwd>
<kwd lng="pt"><![CDATA[Hipermetabolismo]]></kwd>
<kwd lng="pt"><![CDATA[nutrição]]></kwd>
<kwd lng="pt"><![CDATA[paciente queimado]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Porter]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Tompkins]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Finnerty]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Sidossis]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Suman]]></surname>
<given-names><![CDATA[EO]]></given-names>
</name>
<name>
<surname><![CDATA[Herndon]]></surname>
<given-names><![CDATA[ND]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The metabolic stress response to burn trauma: current understanding and therapies]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2016</year>
<volume>388</volume>
<page-range>1417-26</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jeschke]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Post-burn hypermetabolism: past, present and future]]></article-title>
<source><![CDATA[J Burn Care Res]]></source>
<year>2016</year>
<volume>37</volume>
<page-range>86-96</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fagan]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Bilodeau]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Burn intensive care]]></article-title>
<source><![CDATA[J Burn Care Res]]></source>
<year>2016</year>
<volume>37</volume>
<page-range>86-96</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bilodeau]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
<name>
<surname><![CDATA[Coyne]]></surname>
<given-names><![CDATA[ES]]></given-names>
</name>
<name>
<surname><![CDATA[Wing]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The ubiquitin proteasome system in atrophying skeletal muscle: roles and regulation]]></article-title>
<source><![CDATA[Am J Physiol Cell Physiol]]></source>
<year>2016</year>
<volume>311</volume>
<page-range>392-403</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zamudio]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Peña]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Riesgo]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[La ubiquitinación: un sistema de regulación dinámico de los organismos]]></article-title>
<source><![CDATA[Rev Esp Cienc Quím-Biol]]></source>
<year>2012</year>
<volume>15</volume>
<page-range>133-41</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cree]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Wolfe]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Postburn trauma insulin resistance and fat metabolism]]></article-title>
<source><![CDATA[Am J Physiol Endocrinol Metab]]></source>
<year>2008</year>
<volume>209</volume>
<page-range>1-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kraft]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Herndon]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Finnerty]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Hiyama]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Jeschke]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association of postburn fatty acids and triglycerides with clinical outcome in severely burned children]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2013</year>
<volume>98</volume>
<page-range>314-21</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rehou]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Mason]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Burnett]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jeschke]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Burned adults develop profound glucose intolerance]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2016</year>
<volume>44</volume>
<page-range>1059-66</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gore]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Chinkes]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Hart]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
<name>
<surname><![CDATA[Wolf]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Herndon]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Sanford]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hyperglycemia exacerbates muscle protein catabolism in burn-injured patients]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2002</year>
<volume>30</volume>
<page-range>2438-3442</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Randle]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Garland]]></surname>
<given-names><![CDATA[PB]]></given-names>
</name>
<name>
<surname><![CDATA[Hales]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Newsholme]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>1963</year>
<volume>1</volume>
<page-range>785-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moreiraa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Burghiby]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Manzanares]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Metabolismo y terapia nutricional en el paciente quemado crítico: una revisión actualizada]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2018</year>
<volume>42</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>306-16</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<collab>Evidence-Based Guidelines Group ABA</collab>
<article-title xml:lang=""><![CDATA[Practice guidelines for burn care]]></article-title>
<source><![CDATA[J Burn Care Rehabil]]></source>
<year>2001</year>
<volume>22</volume>
<page-range>59-66</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García de Lorenzo y Mateos]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz Leyba]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez Sánchez]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: paciente quemado crítico]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2011</year>
<volume>35</volume>
<page-range>63-7</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rimdeika]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gudaviciene]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Adamonis]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Barauskas]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Pavalkis]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Endzinas]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The effectiveness of caloric value of enteral nutrition in patients with major burns]]></article-title>
<source><![CDATA[Burns]]></source>
<year>2006</year>
<volume>32</volume>
<page-range>83-6</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dickerson]]></surname>
<given-names><![CDATA[RN]]></given-names>
</name>
<name>
<surname><![CDATA[Gervasio]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Riley]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Accuracy of predictive methods to estimate resting energy expenditure of thermally injured patients]]></article-title>
<source><![CDATA[JPENJ Parenter Enteral Nutr]]></source>
<year>2002</year>
<volume>26</volume>
<page-range>17-29</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abdullahi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Jeschke]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nutrition and anabolic pharmacotherapies in the care of burn patients. american society for parenteral and enteral nutrition]]></article-title>
<source><![CDATA[Nutr Clin Pract]]></source>
<year>2014</year>
<volume>29</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>621-30</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jeschke]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Barrow]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
<name>
<surname><![CDATA[Herndon]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Insulin like growth factor I plus insulin like growth factor binding protein 3 attenuates the proinflammatory acute phase response in severely burned children]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2000</year>
<volume>231</volume>
<page-range>246-52</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jeschke]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Herndon]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Wolf]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recombinant human growth hormone alters acute phase reactant proteins, cytokine expression, and liver morphology in burned rats]]></article-title>
<source><![CDATA[J Surg Res]]></source>
<year>1999</year>
<volume>83</volume>
<page-range>122-9</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Takala]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ruokonen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Webster]]></surname>
<given-names><![CDATA[NR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Increased mortality associated with growth hormone treatment in critically ill adults]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>1999</year>
<volume>341</volume>
<page-range>785-92</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Núñez]]></surname>
<given-names><![CDATA[VT]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Millán]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Revisión sistemática del efecto del propranolol sobre el hipermetabolismo del quemado]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2015</year>
<volume>39</volume>
<page-range>101-13</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
