Clinical Nutrition in Gastrointestinal Disease

Alan Buchman, MD, MSPH

Chapter 27: The Metabolic Response To Critical Illness (continued)

Stephen F. Lowry, MD; J. Martin Perez, MD

The metabolic response to critical illness is induced by the endogenous production of a variety of humoral and cellular mediators in response to diverse stimuli including trauma, sepsis, ischemia/reperfusion, and other disease states. This state is characterized by progressive severe loss of body protein, alterations in carbohydrate metabolism, increased oxidation of lipid, and increased extracellular volume that may result in organ dysfunction or failure. This state may be mitigated to some degree by nutritional support but can be reversed only by major palliation or cure of the underlying…