Significance of the hormonal, adrenal, and sympathetic responses to burn injury

Derek Culnan, Charles Voigt, Karel D. Capek, Kuzhali Muthumalaiappan, David Herndon

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations


Under cognitive stress, hormone and neurotransmitter release is conventionally thought to serve in a compensatory manner facilitating the heightened mental awareness along with metabolic and cardiovascular activity that supports rapid increases in muscular work. Thermal injury unquestionably initiates a stress response, with a magnitude proportional to the severity of the injury. However, there are important characteristics of the injury response that contrast with the fight-or-flight response. These include prolonged hormone/neurotransmitter elevation, the absence of increased muscle work limiting metabolic demand, and the presence of massive tissue injury. The second surge of stress hormones is evoked by surgical débridement and complicates the severe metabolic derangements and compromised immune capacity characteristic of the burn course during the initial 7-10 days following injury. In this chapter we present the adrenomedullary-neurotransmitter activation and actions as separate from the adrenocortical activation and actions to clarify specific responses as we currently understand them.

Original languageEnglish (US)
Title of host publicationTotal Burn Care
Subtitle of host publicationFifth Edition
PublisherElsevier Inc.
ISBN (Electronic)9780323497428
ISBN (Print)9780323476614
StatePublished - 2018


  • Androgen
  • Catecholamines
  • Corticosteroids
  • Epinephrine
  • Estrogen
  • Glucocorticoids
  • HPA-axis
  • Hypermetabolism
  • Norepinephrine

ASJC Scopus subject areas

  • General Medicine


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