Nutrition and the metabolic response to injury

Nutrition And Wound Healing

Cuthbertson described the metabolic response to injury as consisting of an ebb phase and a flow phase.2526 The ebb phase is the period of traumatic shock or hypometabolism during the first few hours or days after injury. This phase is soon replaced by the flow phase that is a period of hypermetabolism that may last for weeks or months depending on the nature of the injury and obstacles to recovery. In the case of minor injury, such as elective surgery, both of these phases may be relatively...

Protein and amino acid metabolism

Posttraumatic hypermetabolism is associated with increased catabolism and loss of lean body mass in proportion to the severity of the injury. It is well established that an increased intake of protein is required for wound healing and achievement of nitrogen balance. Patients with sepsis can lose up to 250 g of lean body mass per day if unfed 87 . Muscle proteolysis, a hallmark of protein metabolism in sepsis and trauma, can result in compromised respiratory function and further...

Metabolic Effects of Cytokines in Burns Trauma and Sepsis

Ebb And Flow After Trauma

TNF Primary mediator in inflammatory response, increase in acute phase proteins, reduction in skeletal muscle and diaphragm contractility IL-1 Activation of T cells, iNOS expression, prostaglandin production, inhibition of lipoprotein lipase, procoagulant activity, increase in acute phase proteins IL-6 Key later role in inflammatory cascade, activation of lymphocytes, increase in acute phase proteins, endogenous pyrogen IL-8 Key later role in inflammatory cascade, regulates neutrophil activity...