Energy metabolism in sepsis and injury

Détails

ID Serval
serval:BIB_FA2522ECEDEF
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Energy metabolism in sepsis and injury
Périodique
Nutrition
Auteur(s)
Chiolero  R., Revelly  J. P., Tappy  L.
ISSN
0899-9007 (Print)
Statut éditorial
Publié
Date de publication
09/1997
Volume
13
Numéro
9 Suppl
Pages
45S-51S
Notes
Journal Article
Review --- Old month value: Sep
Résumé
The development of malnutrition is often rapid in critically ill patients with sepsis and severe trauma. In such patients, a wide array of hormonal and nonhormonal mediators are released, inducing complex metabolic changes. Hypermetabolism, associated with protein and fat catabolism, negative nitrogen balance, hyperglycemia, and resistance to insulin, constitute the hallmark of this response. Critically ill patients demonstrate a marked alteration in the adaptation to prolonged starvation: resting metabolic rate and tissue catabolism stay elevated, while ketogenesis remains suppressed. The response to nutrition support is impaired. Substrate use is modified in septic and traumatized patients. Glucose administration during severe aggression does not suppress the enhanced hepatic glucose production and the lipolysis. This phenomenon, related to tissue insulin resistance, ensures a high flow of glucose to the predominantly glucose-consuming cells, such as the wound, the inflammatory, and immune cells, all insulin-independent cells. In addition, the elevated protein catabolism is difficult to abolish, even during aggressive nutrition support. Thus, in patients with prolonged aggression, these alterations produce a progressive loss of body cell mass and foster the development of malnutrition and it dire complications. In this review, the relevant physiologic data and the nutritional implications related to energy metabolism in septic and injured patients are discussed, while potential therapeutic strategies are proposed.
Mots-clé
Basal Metabolism *Energy Metabolism Human Growth Hormone/therapeutic use Humans Insulin-Like Growth Factor I/therapeutic use Nutritional Support Sepsis/*metabolism Wounds and Injuries/*metabolism
Pubmed
Web of science
Création de la notice
24/01/2008 14:36
Dernière modification de la notice
03/03/2018 22:55
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