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Books > Medicine > Other branches of medicine > Accident & emergency medicine
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Metabolism and Artificial Nutrition in the Critically Ill (Paperback, 1999 ed.)
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Metabolism and Artificial Nutrition in the Critically Ill (Paperback, 1999 ed.)
Series: Topics in Anaesthesia and Critical Care
Expected to ship within 10 - 15 working days
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The critically ill patient in intensive care may present with
serious metabolic alterations caused directly by the illness or
secondarily by complications (e.g. infections, organ failure or
sepsis) developing within a few hours of hospitaliza tion or in the
following days. Among the situations which maintain and further
trigger rapidly evolving altered metabolism are complex hormonal
reactions, particularly those of the
hypothalamus-hypophysis-adrenal axis, and abnormal stimulation of
the autonomic nervous system. In fact, the sympathetic nervous
system is known to cause significant metabolic alterations. For
example, a surgery patient afflicted by septic complications may
become hypercatabolic and experience significant nitrogen loss; the
altered protein metabolism may in turn heavily influence
carbohydrate and lipid metabolism as well. Thus, it is apparent
that for optimal care of patients with altered metabolic functions,
further knowledge is necessary regarding the physiopathology of
metabolism and the physiopathological mechanisms, which alter the
consump tion of principal energy substrates. Many experimental and
clinical studies have investigated the metabolic aspects of
individual organs or organ systems. However, for a correct
evaluation of such metabolic events, in addition to studying the
roles of metabolic enzymes, active metabolites, and the glutathione
system, it is interesting to consider the use of indirect
calorimetry as a valid and important investigative technique. The
critically ill patient with major alterations in nutritional status
may require artificial nutritive support administered through
either parenteral or enteral routes."
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