1. Physiopathologie du patient agressé en réanimation
- Author
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Chioléro, R.L.
- Subjects
- *
PROTEIN metabolism , *METABOLISM , *ALIMENTARY canal , *INFLAMMATORY mediators , *BIOCHEMISTRY , *PHYSIOLOGY - Abstract
Abstract: An ICU patient reacted to multiple trauma, sepsis, etc. with extensive physiological responses including release of endocrine and inflammatory mediators (pro-inflammatory cytokines, stress hormones, etc.) and activation of several systems (sympathic, coagulation, immune, etc.) Energy expenditure was heightened and progressive erosion of the proteic compartment was observed. The mechanisms of protein catabolism are complex, with catabolism in muscle and anabolism elsewhere, which vary depending on the clinical situation. Oxidative stress is high and the antioxidant defenses are brought into play (enzymatic and nonenzymatic). The digestive tract, a victim of these different responses, also aggresses the body by translocatiog bacteria and toxins and releasing mediators. Even if the causal mechanisms are not elucidated, enteral nutrition has shown its beneficial effects on the digestive tract. It is associated with a reduction in infection and a less severe systemic response on the part of the body. [Copyright &y& Elsevier]
- Published
- 2007