MEDI7212 Lecture 66: W9 - Stress response to trauma
Document Summary
Stress response refers to the hormonal and metabolic changes that follow injury and trauma, encompassing endocrinological, immunological and hematological effects. Sns activation, endocrine (pituitary hormone release, insulin resistance), immunological and hematological (cytokine release, acute phase reaction, neutrophil leukocytosis, lymphocyte proliferation) Stress response is initiated inappropriately during surgical practice, thus strenuous efforts have been made to inhibit the stress reponse to surgery (eg anaesthesia, neural blockage: hormonal changes. Increase: blood glucose, carbohydrate metabolism via cortisol and catecholamines, diabetic complications in surgery. Lack of insulin and peripheral insulin resistance: amino acids, protein metabolism via cortisol. Fat (tg) metabolism via cortisol, catecholamines, gh: glycerol used in gluconeogenesis. Fatty acids used in ketone bodies or re-esterified. Stress activation: water and na, avp promotes water retention & concentrated urine, aldosterone via raas promotes water and na reabsorption, overall = increased catabolism of carbs/ fat/ protein & inhibited anabolism.
