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Carbohydrate metabolism in trauma

D W Wilmore

    Clinics in Endocrinology and Metabolism
    |November 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Following injury, glucose metabolism shifts to a hypermetabolic state. This involves increased glucose cycling, driven by the sympathetic nervous system, to support tissue repair and energy demands.

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    Area of Science:

    • Metabolic responses to injury
    • Physiology of trauma
    • Energy metabolism in critical illness

    Background:

    • Injury triggers distinct metabolic phases: initial shock ('ebb') and hypermetabolism ('flow').
    • Understanding glucose kinetics is crucial for managing trauma patients.

    Purpose of the Study:

    • To elucidate the dynamics of glucose metabolism during the hypermetabolic phase of injury.
    • To explore the role of the sympathetic nervous system and metabolic cycles in post-injury energy supply.

    Main Methods:

    • Analysis of body glucose concentration and mass flow.
    • Investigation of hepatic gluconeogenesis and peripheral glucose conversion.
    • Examination of the Cori and alanine cycles in nutrient transport.

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    Main Results:

    • Increased hepatic glucose production and peripheral conversion to three-carbon precursors.
    • Markedly increased glucose mass flow during the 'flow' phase, linked to injury severity and sympathetic activity.
    • Correlation between six- to three-carbon cycling rate and increased oxygen consumption.

    Conclusions:

    • The hypermetabolic state is characterized by an essential glucose cycling system supporting inflammatory response and tissue repair.
    • Sympathetic nervous system activity is a primary driver of altered glucose flow post-injury.
    • This metabolic adaptation is fundamental for recovery, though influenced by various external factors.