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La respuesta al estrés metabólico al trauma por quemaduras: conocimiento y terapias actuales
Craig Porter1, Ronald G Tompkins2, Celeste C Finnerty1
1Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA; Shriners Hospitals for Children, Galveston, TX, USA.
Lancet (London, England)
|October 7, 2016
Resumen
Las quemaduras graves causan una respuesta prolongada al estrés, lo que lleva al hipermetabolismo y al desgaste muscular. Se necesitan nuevas estrategias para gestionar esta respuesta y mejorar los resultados para los sobrevivientes de quemaduras.
Área de la Ciencia:
- Ciencias biomédicas
- Investigación sobre el trauma
- Trastornos del metabolismo
Sus antecedentes:
- Las quemaduras graves desencadenan una respuesta de estrés fisiológico extrema y duradera.
- Esta respuesta al estrés, incluido el hipermetabolismo y el desgaste muscular, puede persistir durante años después de la lesión.
- Las estrategias terapéuticas actuales son insuficientes para mitigar por completo los efectos a largo plazo del trauma por quemaduras.
Objetivo del estudio:
- Revisar los conocimientos actuales sobre la respuesta al estrés por un trauma por quemaduras.
- Para centrarse en el hipermetabolismo, el desgaste muscular y la diabetes inducida por el estrés.
- Identificar las lagunas de conocimiento y orientar el desarrollo de nuevas estrategias terapéuticas.
Principales métodos:
- Revisión de la literatura de los desarrollos recientes en la investigación de los traumas por quemaduras.
- Análisis de los mecanismos fisiopatológicos subyacentes a la respuesta al estrés.
- Identificación de las áreas clave para la investigación futura y la intervención terapéutica.
Principales resultados:
- La respuesta al estrés a las quemaduras graves se caracteriza por un hipermetabolismo y catabolismo muscular significativos.
- El estrés inducido por quemaduras puede conducir al desarrollo de diabetes o exacerbar los problemas de control glucémico existentes.
- Quedan importantes lagunas de conocimiento en la comprensión y el manejo de las secuelas metabólicas crónicas de las quemaduras.
Conclusiones:
- Una respuesta de estrés profunda y persistente es una característica de una lesión grave por quemaduras.
- Abordar el hipermetabolismo, el desgaste muscular y la diabetes inducida por el estrés es fundamental para mejorar los resultados de los sobrevivientes de quemaduras.
- Es esencial realizar más investigaciones para desarrollar estrategias terapéuticas eficaces para mitigar las consecuencias metabólicas a largo plazo de las quemaduras.
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