Gore and his colleagues have performed an elegant study on febrile children with burn wounds. They studied the effects of fever on the metabolic response in these patients and have prepared an excellent article. The study was designed to define the energy "cost" of fever in these patients by using indirect calorimetry and the net flux of phenylalanine across the leg as an index of muscle catabolism. Febrile patients, as expected, exhibited increases in heart rate, serum glucose level, oxygen consumption, and energy expenditure. Indeed, febrile patients also exhibited a significantly greater efflux of phenylalanine from the leg compared with patients without fever, indicating an increase in muscle catabolism with fever.
Silen M. Influence of Fever on the Hypermetabolic Response in Burn-Injured Children—Invited Critique. Arch Surg. 2003;138(2):174. doi:10.1001/archsurg.138.2.174