A wide variety of factors and processes are involved in the metabolic response to critical illness; this chapter reviews some of these factors and metabolic responses in the critically ill surgical patient to help the clinician minimize patient debility. The features of critical illness that can cause debility include wounds, pain, inflammation, infection, and iatrogenic factors. The three major features of the metabolic response are discussed: the hyperdynamic or hypermetabolic state, muscle wasting, and glucose intolerance. Other topics considered include altered temperature regulation, the role of the central nervous system, the role of the gut, manipulating the response to critical illness, altered protein metabolism, altered carbohydrate metabolism, and systemic mediators (e.g., hormones and cytokines).
This review contains 3 highly rendered figures, 17 tables, and 59 references
Keywords: Critical illness, metabolic response, thermoregulation, muscle wasting, glucose intolerance, burn victim, sepsis
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