What electrolyte imbalance is often seen three days after a burn injury?

After a burn injury, patients typically experience alterations in their fluid and electrolyte balance due to the loss of skin integrity, which can significantly disrupt homeostasis. In the initial phase following a burn, there is often a release of intracellular potassium into the extracellular space due to cell damage, leading to hyperkalemia. However, as fluid resuscitation begins and the body starts to exhibit a diuretic phase around three days post-injury, the kidneys may excrete excess potassium, resulting in hypokalemia.

This is particularly relevant considering that burn injuries lead to an increased metabolic rate and, subsequently, a higher potassium requirement, which the body may struggle to meet if diuresis occurs excessively. Consequently, by the third day post-burn, particularly in those receiving appropriate fluid and nutritional management, hypokalemia is the expected finding, as the initial intracellular shift and subsequent diuresis can lower serum potassium levels.

Maintaining awareness of these shifts in electrolyte balance is crucial for the management of burn patients, as both hyperkalemia and hypokalemia can have severe cardiovascular and neuromuscular consequences if not monitored and treated appropriately. Thus, three days after a burn injury, the occurrence of hypokalemia aligns with the expected physiological responses and fluid management