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Septic Shock pp 197-213 | Cite as

Whole Body Energy Metabolism in the Hyperdynamic Phase of Sepsis

  • D. F. Heath
  • R. A. Little
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 4)

Abstract

A patient with sepsis may remain in a hyperdynamic state for weeks or even months, during which heat production, \(\mathop V\limits^. {O_2}\) and nitrogen excretion are above normal while glucose oxidation is somewhat inhibited and glucose uptake does not increase normally with insulin. Successful treatment often consists primarily in feeding the patient enough to sustain the hypermetabolic state as long as sepsis persists; and prognosis has improved markedly since total parenteral nutrition became the norm during severe sepsis. The increase in energy expenditure, as measured by \(\mathop V\limits^. {O_2}\) , cannot all be accounted for by pyrexia [1]. Other factors, such as increased cardiac work, energy expenditure of gluconeogenesis, and oxygen consumption by septic foci, may explain the rest [2], but this is far from certain. Whatever the cause, the energy demand is increased, and must be met, both by the supply of substrates and by the maintenance of a better than normal resting circulation to ensure delivery of O2 to the tissues for their oxidation.

Keywords

Insulin Resistance Septic Patient Total Parenteral Nutrition Ketone Body Glucose Oxidation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • D. F. Heath
  • R. A. Little

There are no affiliations available

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