Surgical Inflammation

Surgical Inflammation

Indexed in: EBSCO, Book Citation Index, Science Edition.

This monograph offers the reader an integrated point-of-view about the inflammatory response related to injury, infections and tumors. This integration is based on the hypothesis that the multiple ...
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The Polytraumatized Patient

Pp. 154-179 (26)

Maria-Angeles Aller, Jose-Ignacio Arias, Laureano Lorente, Isabel Prieto, Alfredo Alonso-Poza and Jaime Arias

Abstract

An interpretation of the metabolic response to injury in patients with severe accidental or surgical trauma is made. In the last century, various authors attributed a meaning to the post-traumatic inflammatory response by using theleological arguments. Their interpretations of this response, not only facilitate integrating the knowledge, but also their flow from the bench to the bedside, which is the main objective of modern translational research. The goal of the current review is to correlate the metabolic changes with the three phenotypes -ischemia-reperfusion, leukocytic and angiogenic that the patients express through the evolution of the systemic inflammatory response. The sequence in the expression of multiple metabolic systems that becomes progressively more elaborate and complex in severe injured patients urges for more detailed knowledge in order to establish the most adequate metabolic support according to the evolutive phase.

Keywords:

Inflammation, trauma, metabolic response, shock, hypothalamicpituitary- adrenal axis, ebb phase, flow phase, acidosis, immunonutrition, metabolic staging, anaerobic glycolysis.

Affiliation:

Cátedra de Cirugía, Facultad de Medicina, Universidad Complutense, Pza. de Ramón y Cajal s.n., 28040 MADRID, Spain.