Table 1 Metabolic changes after major trauma.
From: Metabolic changes after polytrauma: an imperative for early nutritional support
"Ebb" phase (hours) | "Flow" phase (days to weeks) |
|---|---|
Decreased body temperature | Increased body temperature |
Decreased oxygen consumption | Increased oxygen consumption |
Lactate acidosis | Negative nitrogen balance |
Increased stress hormone levels | Increased stress hormone levels |
Decreased insulin levels | Normal to increased insulin levels |
Hyperglycaemia, insulin resistance | Hyperglycaemia, insulin resistance |
Gluconeogenesis | Gluconeogenesis |
Increased substrate consumption | Proteinolysis ("autocannibalism") |
Hepatic acute-phase response | Lipolysis |
Immune activation | Immunosuppression |