Anabolic hormones in critically ill patients.
Critical illness and severe injury induce a number of neuroendocrine changes that initially enhance survival. However, for skeletal muscle, the hormonal environment is such that accelerated catabolism predominates. The prevailing hypercortisolemia is exacerbated by a resistance to or decreased production of anabolic hormones, or both. The resulting loss of lean body mass compromises the patient's ability to handle acute complications and impairs efforts towards rehabilitation. For these reasons, efforts have been focused upon the restoration of the anabolic influence. Recent studies continue to demonstrate that the amelioration of muscle catabolism is possible with hormonal management. Emerging technologies and conservative administration regimens hold promise for the development of the clinical ability to restore anabolic influence, while minimizing undesirable side effects.
Ferrando
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Department of Surgery, University of Texas Medical Branch, Galveston 77550, USA. aferrand@sbi.utmb.edu
D016638:Critical Illness; D006728:Hormones / Q000096:biosynthesis / Q000378:metabolism / Q000502:physiology*; D019382:Human Growth Hormone / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000502:physiology; D007334:Insulin-Like Growth Factor I / Q000502:physiology; D013739:Testosterone / Q000502:physiology
D006728:Hormones; D007328:Insulin; D019382:Human Growth Hormone; D013739:Testosterone; D007334:Insulin-Like Growth Factor I