title: Metabolic considerations in management of surgical patients.
abstract: Metabolic changes after surgery, trauma, or serious illness have a complex pathophysiology. The early posttraumatic stress response is physiologic and associated with a state of hyperinflammation, increased oxygen consumption, and increased energy expenditure. These are part of a systemic reaction that encompasses a wide range of endocrinological, immunologic, and hematological effects. Surgery initiates changes in metabolism that can affect virtually all organs and tissues; the metabolic response results in hormone-mediated mobilization of endogenous substrates that leads to stress catabolism. Hypercatabolism has been associated with severe complications related to hyperglycemia, hypoproteinemia, and immunosuppression. Proper metabolic support is essential to restore homeostasis and ensure survival.
authors.affiliation: Center for the Study of Nutrition Medicine, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Feldberg 880 East Campus, 330 Brookline Avenue, Boston, MA 02215, USA. gblackbu@bidmc.harvard.edu
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
mesh_terms: D000818:Animals; D003167:Complement Activation / Q000502:physiology; D016207:Cytokines / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology; D006801:Humans; D007107:Immune System / Q000502:physiology; D007111:Immunity, Cellular / Q000502:physiology; D008099:Liver / Q000502:physiology; D008660:Metabolism / Q000502:physiology; D016328:NF-kappa B / Q000502:physiology; D011184:Postoperative Period; D011506:Proteins / Q000378:metabolism; D013312:Stress, Physiological / Q000502:physiology*; D013514:Surgical Procedures, Operative; D014157:Transcription Factors / Q000502:physiology; D014945:Wound Healing / Q000502:physiology
chemical_list: D016207:Cytokines; D016328:NF-kappa B; D011506:Proteins; D014157:Transcription Factors