title: Nutritional support: we have failed in our ability to support patients with sepsis and cancer.
abstract: Despite the success of both parenteral and enteral nutrition in supporting patients who cannot eat, patients with either sepsis or cancer cannot be adequately supported. A proposed mechanism by which aerobic glycolysis leads to a shortage of energy production in the liver is discussed. According to this hypothesis, the proximity of sodium-potassium ATPase and glycogen, its fuel source, leads to the continuation of gluconeogenesis with continued proteolysis and muscle wasting. Myostatin and lipokine, newly discovered factors, may also play a role.
authors.affiliation: Harvard Medical School, Renaissance Park, 1135 Tremont Street, Suite 511-512, Boston, MA 02120, USA. jfische1@bidmc.harvard.edu
authors.forename: Josef E
authors.initials: JE
authors.lastname: Fischer
mesh_terms: D003422:Critical Care / Q000266:history; D016638:Critical Illness / Q000628:therapy*; D005943:Gluconeogenesis / Q000502:physiology*; D006019:Glycolysis / Q000502:physiology*; D049673:History, 20th Century; D006801:Humans; D007773:Lactates / Q000097:blood; D008099:Liver / Q000378:metabolism; D009131:Muscle, Smooth, Vascular / Q000378:metabolism; D009369:Neoplasms / Q000378:metabolism* / Q000628:therapy*; D018529:Nutritional Support; D010289:Parenteral Nutrition, Total / Q000266:history; D018805:Sepsis / Q000378:metabolism* / Q000628:therapy*
chemical_list: D007773:Lactates