RT Book, Section
A1 Mogensen, Kris M.
A1 Robinson, Malcolm K.
A2 Doherty, Gerard M.
SR Print(0)
ID 1171274658
T1 Surgical Metabolism & Nutrition
T2 Current Diagnosis & Treatment: Surgery, 15e
YR 2020
FD 2020
PB McGraw Hill LLC
PP New York, NY
SN 9781260122213
LK accessmedicine.mhmedical.com/content.aspx?aid=1171274658
RD 2024/04/19
AB The  human  body  responds  to  surgical  trauma,  infection,  and  critical  illness  in  a  complex  manner.  The  response  is  designed  to  provide  energy  and  essential  substrates  for  reparative  processes  while  protecting  the  host  from  microbial  infection  and  optimizing  vital  organ  function.  Compounds  are  released  from  peripheral  tissues  and  taken  up  by  visceral  organs  for  use  in  these  functions,  which  expedites  recovery  once  the  primary  pathologic  process  has  been  controlled.  The  flow  of  substrates  is  initiated  and  maintained  by  the  neuroendocrine  milieu  as  well  as  a  multitude  of  inflammatory  mediators.  The  catabolic  response  appears  well  orchestrated  but  favors—sometimes  too  exuberantly—abundant  delivery.  Hence,  the  response  may  be  deleterious  when  prolonged  or  severe.  There  may  be  significant  degradation  of  lean  body  mass,  which  can  result  in  debility  and  death  if  nutritional  and  cardiopulmonary  reserves  are  exhausted.  The  magnitude  and  extent  of  the  catabolic  state  is  proportional  to  the  incipient  injury.  One  goal  of  surgeons  and  others  who  care  for  seriously  ill  patients  is  to  support  the  salutary  components  of  the  response  to  injury  while  mitigating  the  detrimental  elements.  This  can  be  accomplished  in  part  through  appropriate  nutritional  management  of  the  critically  ill  patient.