Anabolic strategies in critical illness.
Critical illness precipitates a marked catabolic response, with protein wasting and loss of lean body mass. Prolongation of this response leads to impaired immunity, poor wound healing, loss of intestinal barrier function and muscle weakness, thereby increasing morbidity and perhaps mortality. Conventional nutritional support only partially ameliorates this process. Disappointingly, specific anabolic and anticatabolic strategies have so far met with only limited success, although recent findings, in particular studies demonstrating the potential value of aggressive insulin therapy and the administration of growth hormone secretagogues, have been encouraging.
Hadley
Julia S
JS
Intensive Care Unit, St Bartholomew's Hospital, West Smithfield, London, UK.
Hinds
Charles J
CJ
D018663:Adrenergic Agents / Q000627:therapeutic use; D016638:Critical Illness / Q000628:therapy*; D005973:Glutamine / Q000378:metabolism / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism / Q000627:therapeutic use; D018529:Nutritional Support; D013256:Steroids / Q000627:therapeutic use; D013312:Stress, Physiological / Q000378:metabolism
D018663:Adrenergic Agents; D007328:Insulin; D013256:Steroids; D005973:Glutamine; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I