The metabolic response to stress: a case of complex nutrition support management.
The ICU patient with burns, neurotrauma, sepsis, or major surgery typifies the classic hypermetabolic patient. These patients have increased energy and nutrient needs as a result of their injuries and require early nutrition support. Although these patients are likely to benefit from nutritional intervention, the complexity of the stress response to injury and subsequent changes in nutrient metabolism make the design and implementation of nutrition care challenging. This article reviews the pathophysiology of common hypermetabolic conditions and provides strategies to manage the complications associated with nutrition support.
Cartwright
Martina M
MM
Lilly Research Laboratories, Eli Lilly & Company, Indianapolis, IN 46285, USA. drmartinac@aol.com
D000328:Adult; D000465:Algorithms; D002056:Burns / Q000150:complications; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy; D003663:Decision Trees; D002149:Energy Intake; D004734:Energy Metabolism; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D018529:Nutritional Support / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D010101:Oxygen Consumption; D018805:Sepsis / Q000150:complications; D013217:Starvation / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D013312:Stress, Physiological / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D014947:Wounds and Injuries / Q000150:complications
D005947:Glucose