[Post-traumatic metabolism--bases and clinical aspects].

Area of Science:

• Metabolic and Endocrine Responses to Trauma
• Nutritional Therapy Strategies

Context:

• Polytraumatized patients exhibit complex humoral and metabolic changes post-injury.
• Current treatment paradigms require a structured approach to nutritional support.

Purpose:

• To define distinct phases of metabolic response following severe trauma.
• To rationalize nutritional therapy based on these identified phases.

Summary:

• The acute phase (12-24h) is dominated by catecholamines, suppressing insulin and increasing anti-insulin hormones, precluding nutritional therapy.
• The intermediate phase allows gradual nutritional intervention as stabilization occurs, but risks metabolic imbalance.
• The repair phase, lasting weeks, is characterized by insulin dominance and normalized anti-insulin hormones.

Impact:

• Provides a framework for timing and implementing nutritional therapy in trauma care.
• Aims to prevent metabolic complications and improve patient outcomes.
• Applicable to varying degrees of injury, from moderate surgery to severe polytrauma.