Temperature Management in Burn Care

Effective temperature regulation is a cornerstone of modern burn care, addressing the dual challenges of preventing hypothermia during surgical and wound-care procedures and avoiding hyperthermia in the later stages of systemic inflammation or sepsis. Severe burns disrupt the skin’s barrier function, impair endogenous heat production and provoke profound hypermetabolic responses. Consequently, burn patients are prone to rapid heat loss through exposed wounds, yet may also mount exaggerated febrile reactions driven by pro-inflammatory cytokines. Temperature management strategies span passive measures, such as raising ambient room temperature and optimising insulating dressings, to active modalities including forced-air warming systems, heated intravenous fluids and internal heat exchange devices. Clinical guidelines advocate maintaining core body temperature within a narrow normothermic range to reduce metabolic stress, improve coagulation, and minimise infection risk. Emerging evidence emphasises personalised protocols that account for burn extent, patient age and comorbidities, with continuous monitoring enabling real-time adjustments. Advances in surface and internal warming technologies, coupled with an improved understanding of thermoregulatory physiology, are reshaping perioperative and critical-care practices. Globally, multidisciplinary teams integrate temperature control with fluid resuscitation, nutritional support and infection prevention to optimise outcomes, underscoring the central role of thermal homeostasis in comprehensive burn management.

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Temperature Management in Burn Care publication trend

The graph below shows the total number of articles in temperature management in burn care across all publications each year (not limited to Nature Index journals).

Technical terms

Hypothermia: A core body temperature below the normal physiological range, typically defined as under 36 °C, associated with coagulopathy and increased infection risk in burn patients.

Normothermia: Maintenance of core body temperature within a range (generally 36–38 °C) considered optimal for metabolic stability and organ function during burn care.

Oesophageal heat exchanger: An internal warming device inserted into the oesophagus that utilises circulating heated fluid to transfer heat directly to the patient’s core, facilitating rapid and controlled rewarming.

Core-peripheral temperature gradient: The difference in temperature between central (e.g. oesophageal or rectal) and peripheral (skin) sites, used as an indicator of perfusion and thermal homeostasis in critically ill patients.

References

1. Perioperative targeted temperature management of severely burned patients by means of an oesophageal temperature probe. Burns (2022).
2. Mind the Gap! Core-Peripheral Temperature Gradient and Its Relationship to Mortality in Major Burns. European Burn Journal (2025).
3. Survey about target temperature and thermal management in intensive care for severe thermal trauma in burn centres of Germany, Austria and Switzerland. Burns (2024).