What are typical protein and caloric goals for adults with severe burns?

• A. Protein 1.0 g/kg/day and 20-25 kcal/kg/day
• B. Protein 1.5-2.0 g/kg/day and 25-40 kcal/kg/day
• C. Protein 2.5-3.0 g/kg/day and 60-70 kcal/kg/day
• D. Protein 0.8 g/kg/day and 15 kcal/kg/day

Answer: (B)

Severe burns trigger a hypermetabolic, hypercatabolic state that massively increases energy expenditure and protein losses as the body works to repair damaged tissue. To support healing and preserve lean body mass, nutrition must provide enough protein for tissue synthesis and immune function, while also delivering enough calories to spare protein from being used for energy.

The recommended targets—about 1.5–2.0 g of protein per kilogram per day and roughly 25–40 kcal per kilogram per day for energy—reflect this balance. The protein intake supports wound healing, nitrogen balance, and immune response during the catabolic stress of burns. The caloric range accounts for the markedly higher energy needs driven by the burn size, fever, and activity level, while avoiding excessive calories that could lead to fat gain or metabolic complications.

Less protein (for example, around 0.8–1.0 g/kg/day) would not meet the demands of tissue repair, and too low calories (like 15–25 kcal/kg/day) would force the body to break down more protein for energy. On the other hand, very high caloric targets (such as 60–70 kcal/kg/day) without adequate protein to drive synthesis can still fail to optimize healing and may risk metabolic issues. Thus the 1.5–2.0 g/kg/day protein and 25–40 kcal/kg/day energy range best fits the needs of adults with severe burns.