The Metabolic Stress Response and Enhanced Recovery
Injury and surgery immediately cause a series of stress responses in the body. The most important reactions involve the release of stress hormones and cytokines. The level of these reactions is related to the amount of stress inflicted. With greater stress, increasingly stronger reactions cause more marked catabolic reactions. Central to all these reactions is the loss of the normal anabolic actions of insulin, i.e., the development of insulin resistance . Excessive catabolic reactions are generally not beneficial for the body and a state of catabolism continuously breaks down muscle tissue and prolongs recovery. Hence a key aspect of enhancing recovery after surgery is related to minimising the negative metabolic effects by reducing the catabolic responses and having the patient return to a balanced metabolism again.
KeywordsInsulin Resistance Bowel Preparation Surgical Stress Elective Colorectal Surgery Catabolic Response
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