Trauma and aggressive homeostasis management.
Homeostasis refers to the capacity of the human body to maintain a stable constant state by means of continuous dynamic equilibrium adjustments controlled by a medley of interconnected regulatory mechanisms. Patients who sustain tissue injury, such as trauma or surgery, undergo a well-understood reproducible metabolic and neuroendocrine stress response. This review discusses 3 issues that concern homeostasis in the acute care of trauma patients directly related to the stress response: hyperglycemia, lactic acidosis, and hypothermia. There is significant reason to question the "conventional wisdom" relating to current approaches to restoring homeostasis in critically ill and trauma patients.
Department of Anaesthesia and Intensive Care, Galway University Hospitals, Galway, Ireland. Patrick.neligan@hse.ie
Patrick J
PJ
Neligan
Dimitry
D
Baranov
D000140:Acidosis, Lactic / Q000628:therapy; D001930:Brain Injuries / Q000628:therapy; D006706:Homeostasis; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy; D007036:Hypothermia, Induced; D007328:Insulin / Q000627:therapeutic use; D019344:Lactic Acid / Q000378:metabolism; D010100:Oxygen / Q000097:blood; D012771:Shock, Hemorrhagic / Q000628:therapy; D014947:Wounds and Injuries / Q000628:therapy*
D007328:Insulin; D019344:Lactic Acid; D010100:Oxygen